No abstract available.
Adolescent* ; Female* ; Humans

Acquired syphilis rarely manifest itself in the skeleton, causing localised osteoscopic pain, commonly in the abscence of general systemic complaints. Diagnosis of bone syphilis can easily be made by clinical history, course of the disease, roentgeno-graphic findings, serological tests, therapeutic test of antiluetic treatment and, most reliably, by biopsy. We experienced a patient with syphilitic osteomyelitis of tbe tibia who had a history of sexual contact and the diagnosis was confirmed by serological tests and biopsy.
Biopsy ; Diagnosis ; Humans ; Osteomyelitis ; Serologic Tests ; Skeleton ; Syphilis ; Tibia

Scurvy is a manifestation of deficiency of vitamin C, which was characterized by follicular hyperkeratosis, hemorrhagic manifestation, fatigue, muscular ache and pains, swollen jonts, swollen bleeding gums, and peripheral edema. Rescently we experienced a cases of scurvy in 13 month old boy who had been nourished by artificial feedings with ricegruel without additional vitamin C. Rentgenographic findings of bone revealed rosaries in all costochondral junctions and typical scorvutic changes in both femur. Scury is very rare disease in korea now. A brief review of literature was done.
Ascorbic Acid ; Edema ; Femur ; Gingiva ; Hemorrhage ; Humans ; Infant ; Korea ; Male ; Muscle Fatigue ; Rare Diseases ; Scurvy*

A clinical study was carried out on 575 cases with tuberculous meningitis who were admitted to the department of pediatrics, Yonsei University College of Medicine during the 18 years from January 1959 to December 1976. The following results were obtained. 1.The age incidence was highest in the age of 2 to 5 and 89.1% were under the age of 8 years. Male to female ratio was 1.5:1 2.The seasonal incidence in order of frequency were spring (30.9%), summer (25.9%), autumn(20.8%) and winter (22.4%). 3. 25% out of the 575 cases had the source of infection infamily members. 4. The tuberculous skin test showed positive reaction in 53.5% 5. The common chief complaints in order of frequency were fever, vomiting, convulsion, unconsciousness and headache. 6. At the time of admission, 80% of 575 cases were diagnosed as meningitis. 7. The major neurologic findings were unconsciousness (34.7%) neck stiffness (86.2%) and positive Kernings sign(62.7%) 8. Chest X-Ray showed normal in 11.6% an miliary tuberculous in 13.7% 9. According to the findings of C.S.F., increased pressure, high protein and low sugar level were associated with poor prognosis. But there were no significant differences on mortality in relation with cell count and chloride level. 10.Mortality rate was 17.5%. Highest mortality was noted in young infants.
Cell Count ; Female ; Fever ; Headache ; Humans ; Incidence ; Infant ; Male ; Meningitis ; Mortality ; Neck ; Neurologic Manifestations ; Pediatrics ; Prognosis ; Seasons ; Seizures ; Skin Tests ; Thorax ; Tuberculosis, Meningeal* ; Unconsciousness ; Vomiting

Background: The use of topical antibiotics (TA) for prophylactic purposes after clean dermatologic procedures (CDP) is generally not recommended, and the prescription of TA needs to be individualized in consideration of each patient’s situation and underlying disease. The aim of this study was to determine the proportion of patients who underwent CDP in outpatient settings and were prescribed TA inappropriately, as well as the factors that may affect the prescription of TA. Methods: Outpatient visits coded for CDP were selected using claims data from the Health Insurance Review and Assessment Service in 2018. Of these, patients receiving TA prescriptions were classified as having inappropriate TA use, and the proportion was estimated through technical analysis. A logistic regression analysis was used to identify factors influencing inappropriate prescriptions. Results: Data were analyzed using 423,651 visits, and TA was prescribed for approximately 1.9% of the visits. TA usage was higher among women (2.0%), 0–19 years of age (2.2%), medical aid (2.2%), clinic settings (2.4%), and metropolitan areas (2.0%). TA was prescribed more frequently in urology (8.6%), pediatrics (5.0%), and dermatology (4.2%) than in other specialties. Conclusion The prescription rate of TA after CDP was 1.9% using the 1.4 million patient sample from the national health insurance claims data in Korea, which is equally weighted to represent 50 million people. Although the proportion of inappropriate TA prescriptions in Korea is lower than that in other nations, it cannot be overlooked because of the large number of cases. Efforts to improve quality are required to reduce the number of inappropriate prescriptions.

PURPOSE: In children with simple obesity, spontaneous and stimulated growth hormone (GH) secretion are diminished, but their heights usually are normal or even taller for their age and sex. The exact mechanism to explain the discrepancy between impaired GH secretion and normal height velocity has not been elucidated. In this study, we aimed to determine the level of serum growth factors, and the degree of insulin-like growth factor binding protein (IGFBP)-3 proteolysis, and to assess the alteration of the IGF system associated with accelerated or normal growth in simple obesity. METHODS: We evaluated serum growth factors, and IGFBP-3 proteolysis in 27 obese, 25 obesity risk group, and 28 age-matched control group. We measured serum levels of insulin-like growth factor (IGF)-I, IGFBP-1, -3, and free IGF-I by immuno-radiometric assay and IGFBP-3 fragment by Western immunoblotting. RESULTS: The height was taller in obese children than in lean control group. The results showed no significant difference in the level of serum total IGF-1 and IGFBP-3 between obese and normal control group. Although there was no significant difference in other components, serum free IGF-I levels were significantly increased (P<0.05) and showed positive correlation with their height in obese children (r=0.25, P<0.05). The degree of IGFBP-3 proteolysis was increased in obesity and obesity risk group compared to control group. The densities of the IGFBP-3 proteolytic fragment approximate 18 kDa also showed positive correlation with levels of free IGF-I (r=0.23, P<0.05) and height (r=0.19, P<0.05). CONCLUSION: These findings may suggest that elevated levels of serum IGFBP-3 proteolytic fragments showing decreased affinity to IGF-I result in the increase of biologically active free IGF-I, thereby maintain normal growth in the obese children.
Blotting, Western ; Carrier Proteins ; Child* ; Growth Hormone ; Humans ; Insulin-Like Growth Factor Binding Protein 1 ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Intercellular Signaling Peptides and Proteins* ; Obesity* ; Proteolysis*

We report a case of spontaneous renal rupture in a 63 year-old woman as a complication of diabetes mellitus. She experienced a sudden onset of severe pain and bulging mass on the left flank. She had been suffered from diabetes mellitus for 30 years without any specific treatment, and she had no history of specific associated diseases or factors such as trauma, stone, tumor, hydronephrosis or vascular lesion of the kidney. Grossly this ruptured kidney showed a characteristic necrosis and infarcted lesions extended from papilla to cortex of the upper pole kidney and surrounding tissues of the kidney showed interstitial fibrosis, tubular atrophy and mononuclear cell infiltration. Microscopically the atherosclerotic medium-sized blood vessels and small vessels around the infarcted lesion also showed hyaline sclerosis. This pathologically defined spontaneous renal rupture is thought to be caused by focal renal infarction due to atherosclerosis or fat emboli-associated renovascular occlusion in diabetic patient. This report emphasizes the importance of diabetic nephropathy as a new cause of the spontaneous renal rupture in patients of diabetes mellitus.
Atherosclerosis ; Atrophy ; Blood Vessels ; Diabetes Mellitus* ; Diabetic Nephropathies ; Female ; Fibrosis ; Humans ; Hyalin ; Hydronephrosis ; Infarction ; Kidney* ; Middle Aged ; Necrosis ; Rupture ; Rupture, Spontaneous* ; Sclerosis

PURPOSE: To evaluate the results of the treatment of the hip fractures in elderly hemiplegic CVA patients with disuse osteoporosis. Hemiplegic CVA patients have much difficulties in rehabilitation such as walking, daily activity of living and so forth. MATERIALS AND METHODS: The clinical records on thirty-four CVA patients who had undergone the treatment in hip fracture and followed more than 12 months of period between March 1998 and March 2004 were retrospectively reviewed. The treatment methods were 22 cases of bipolar hemiarthroplasty, 6 cases of compression hip screw, 3 cases of ender nail, 3 cases of multiple cannulated screw. We compared the groups underwent bipolar hemiarthroplasty (Group I), internal fixation (Group II), fracture in ipsilateral (Group A), fracture in contralateral (Group B). We evaluated the results by modified Harris hip score, walker ambulation time, walking ability and activity of daily living. RESULTS: The mean postoperative modified Harris hip score was decreased in Group I (11.7 points), Group II (9.6 points), Group A (10.0 points), Group B (12.3 points). Recovery of preoperative walking ability was achieved in total 21 cases (62%) that 7 cases (58%) were observed in Group I, 14 cases (64%) in Group II, 18 cases (67%) in Group A and 3 cases (43%) in Group B. Basic activity of daily living was possible in 18 cases (53%). CONCLUSION: Hemiplegic CVA patients with hip fracture have much difficulties in rehabilitation. However, with appropriate treatment and confident positive attitude for rehabilitations of the patients, doctors and family members, we can expect more reliable results close to the pre-injury status in terms of walking ability and activity of daily living.
Aged* ; Hemiarthroplasty ; Hip Fractures ; Hip* ; Humans ; Osteoporosis ; Rehabilitation ; Retrospective Studies ; Stroke* ; Walkers ; Walking

PURPOSE: To evaluate the rate of mortality for the elderly patients after treatment of hip fractures and analyze the associated risk factors which might affect their mortality rate. MATERIALS AND METHODS: About the clinical records on 305 patients who had undergone the treatment in hip fractures, we evaluated the mortality rate of the total number of 248 patients whose age between 70 and 103 who were followed more than 12 months of period between March 1994 and March 2003. The mean age was 81.3 years. The composition of each female and male were 176 and 72 cases respectively. 99 cases were femoral neck fractures, and 149 cases were femoral intertrochanteric fractures. The operation included bipolar hemiarthroplasty and internal fixation using multiple cannulated screws, compression hip screws and Ender nails. We compared and analyzed the relating factors for the mortality rate. RESULTS: The mean postoperative mortality rate was 14.1% (35 cases). The highest mortality rate showed for the postoperative 3 months which was 57.1% (20 cases), between 4 and 6 months was 25.7% (9 cases), and 17.1% (6 cases) were presented for 7 and 12 months. The postoperative mortality rate within 1 year was affected by underlying diseases, ASA (American society of Anesthesiologists) and cemented bipolar hemiarthroplasty. but, there were no significant difference of the other factors such as the age, gender, osteoporosis and delayed operation. CONCLUSION: The variable factors which affect the mortality rate of the hip fractures in the elderly patients whose age over 70 were mostly determined by underlying diseases, ASA grade, and cemented bipolar hemiarthroplasty. Further study should be necessary for the factors influencing on the mortality rate.
Aged* ; Female ; Femoral Neck Fractures ; Hemiarthroplasty ; Hip Fractures ; Hip* ; Humans ; Male ; Mortality* ; Osteoporosis ; Risk Factors

Renal angiomyolipomas are benign mixed mesenchymal tumors, which are composed of atypical blood vessel, smooth muscle and fat cells. A 34-year-old woman presented with a palpable right abdominal mass, accompanied with discomfort. A CT scan showed a large right perinephric mass, with heterogeneous density, surrounding the kidney, with enlargement of the regional lymph nodes. The presumptive diagnosis was one of a malignant tumor of the retroperitoneum, with lymph node metastasis or an angiomyolipoma, involving both the kidney and lymph nodes. A right radical nephrectomy, including the tumor, was performed. The final diagnosis was an angiomyolipoma arising from the kidney, with the dissected lymph nodes having the same pathology. There was no evidence of a tumor recurrence during the six month follow-up period. This was an unusual case of a multicentric angiomyolipoma.
Adipocytes ; Adult ; Angiomyolipoma* ; Blood Vessels ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Kidney ; Lymph Nodes* ; Muscle, Smooth ; Neoplasm Metastasis ; Nephrectomy ; Pathology ; Recurrence ; Tomography, X-Ray Computed