No abstract available.
Perilymph* ; Sodium Salicylate* ; Sodium*

The clincal experience of thirteen patients with proven acute osteomyelitis under twelve years of age treated by surgical exprolation such as immediate decompression followed by continuous suction-irrigation. Five patients of them who had short duration from the onset improved while three patients who had long duration from the onset had persisting inflammatory change of the bone in spite of the regimen. The causating organisms were mostly staphylococcus aureus in bacterial cultures. The combination of gentamycin, minocin and penclox were the antibiotics of choice. Early diagnosis and early operation is advocated to attain good results in the treatment of acute osteomyelitis in the children.
Anti-Bacterial Agents ; Child ; Decompression ; Early Diagnosis ; Gentamicins ; Humans ; Minocycline ; Osteomyelitis ; Staphylococcus aureus

Bacterial infection has been implicated in premature labor in human. But it is impossible to undergo human study of bacteria-induced preterm delivery. If we carry out animal experiment which simulate human preterm delivery induced by bacteria, studies for mechanism, diagnosis, and treatment of preterm delivery will be progressed rapidly. To elucidate mechanisms and potential intervention strategies in preterm pregnancy loss, we observed bacteria-induced preterm labor and the protecting effect of administration of antibiotics with hysteroscopy-guided intracervical inoculation of Escherichia coli. Sterile saline solution(group I, n=5) or 2x10(7)cfu (colony-forming units) of E. coli bilaterally in the cervix of pregnant New Zealand White rabbits on day 20 or 21(70% of gestation) by hysteroscopy was inoculated and rabbits were assinged to ampicillin-sulbactam therapy beginning at 0hr(group II, n=4), 2 hr(group III, n=4), 4 hr(group IV, n=2), and 16 hr(group V, n=2) after inoculation with E. coli, or to no antibiotic therapy(group VI, n=3). Unasyn(ampicillin-sulbactam) was used and its daily dosage was 100 mg/kg/day. The occurrence of vaginal bleeding or preterm birth was observed every two hours. If one rabbit fetus was found to be delivered, exploratory laparotomy was done. Amniotic fluid culture on each sac, decidual culture on each uterine cavity, and pathologic examinations on each placenta were done. The results of experiments are as follows. In control group(0.2cc sterile saline inoculation only), there was no preterm labor and no bacterial growth in culture. In all three rabbits in group VI, preterm delivery occurred and the culture results were all positive in maternal blood, decidua, and amniotic sacs. Preterm delivery also occurred in group V, but results of maternal blood culture were all negative. Increased trend in the occurrence of preterm delivery was statistically significant in the order(p < 0.05) : group I(0/5), group II(0/4), group III(0/4), group IV(0/2), group V(2/2), and group VI(3/3). Pregnancy outcomes on the basis of the number of living fetus, dead fetus, and macerated fetus, have significant trend in the above order. Amniotic fluid culture results also had significant relationship(p < 0.05) : group I(0.20), group II(20/26), group III(18/30), group IV(10/11), and group VI(7/7). In group V, amniotic fluid fail to be obtained due to severe oligohydramnios. Decidual culture results also had an increased trend; group I(0/32), group II(21/29), group III(20/30), gorup IV(16/16), gorup V(11/11), and group VI(25/25). It is statistically significant(p < 0.05) Incidence of histologic chorioamnionitis was also significantly increased from group I to VI. These results indicate that E. coli inoculation has induced preterm delivery and antibiotic therapy has somewhat prevented preterm birth, amniotic fluid infection, decidual infection, and histologic chorioamnionits. Antibiotic effects were attenuated in cases of delayed antibiotic administration.
Amniotic Fluid ; Animal Experimentation ; Anti-Bacterial Agents* ; Bacteria ; Bacterial Infections ; Cervix Uteri ; Chorioamnionitis ; Decidua ; Diagnosis ; Escherichia coli ; Female ; Fetus ; Humans ; Hysteroscopy ; Incidence ; Laparotomy ; Models, Animal ; Obstetric Labor, Premature ; Oligohydramnios ; Placenta ; Pregnancy ; Pregnancy Outcome ; Premature Birth ; Prognosis* ; Rabbits ; Uterine Hemorrhage

No abstract available.
Free Tissue Flaps*

No abstract available.
Fluoroimmunoassay* ; Immunoenzyme Techniques*

Chest CT is the most useful modality in the diagnosis of primary lung cancer, particularly in patients with recurrent pneumonia which are resistant to antibiotic therapy and in high risk age groups for cancer, The purpose of this examination is to assess the usefulness of CT in pneumonia types of lung cancer. The authors retrospectively analyzed 15 histologically proven cases of pneumonic type lung cancer, which had no evidence of primary lung mass, mediastinal lymphadenopathy or other metastatic lesion on piain chest radiography. On CT scan, a primary lung mass was identified in 13 patients(87%, bronchial obstruction was identified in 12 patients(80%), and metastatic foci was found in the bone(one patient), liver(one patient), and spleen(one patients). In Conclusion, CT scan is a useful method to detect the mediastinal lymphadenopathy or pulmonary mass and also should be the initial radiolographic procedure for diagnosis of lung cancer in patients with recurrent pneumonia on simple chest radiography.
Diagnosis ; Humans ; Lung Neoplasms* ; Lung* ; Lymphatic Diseases ; Methods ; Pneumonia* ; Radiography ; Retrospective Studies ; Thorax ; Tomography, X-Ray Computed

From Mar. 1984 to Mar. 1994, we carried out 18 revision operations in patients who received Girdlestone operation due to the infection of hip was 7 cases, tuberculosis of hip was 3 cases, deep infections after implant insertion of hip were 5 cases, and pyogenic sequela was 1 case. The mean conversion period was 27 months. The leg length discrepancy, range of motion of hip, and Trendelenberg gait were examined before and after conversion to a total hip arthroplasty. The last functional state was evaluated and radiological examination was performed. In summary and Conclusion; 1. The time of performing revision hip arthroplasty was assessed by clinical, radiologic and laboratory finding, and the average time of conversion to total hip arthroplasty was 7.6 months after Girdlestone operation. 2. There was no case of recurrence of infection after revision operations. 3. At last follow-up after revision hip arthroplasty, the mean Harris Hip Score was 87.2(69.6–92.2) point. 4. Six patients had no pain, 8 patients had mild pain, and 2 patients had moderate pain. Nine patients were able to walk without ambulatory aids and 7 patients needed crutch or cane for walking. 5. At the time of revision hip arthroplasty, the average shortening of the resected limb was 4.2cm(1.6–7.3cm), and after revision operation, the average shortening was reduced to 1.2cm(0.8–2.2cm) 6. The technical difficulties, such as increased bleeding, bone deficiency, scar tissue formation, and limb shortening were encountered in all cases. 7. The peroneal nerve injury was developed in one patient who had conversion hip arthroplasty at 13 months after Girdlestone operation.
Arthroplasty ; Arthroplasty, Replacement, Hip ; Canes ; Cicatrix ; Extremities ; Follow-Up Studies ; Gait ; Hemorrhage ; Hip ; Humans ; Leg ; Peroneal Nerve ; Range of Motion, Articular ; Recurrence ; Tuberculosis ; Walking

No abstract available.
Female ; Humans ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy*

PURPOSE: Long-term follow-up results of concurrent bilateral or unilateral cementless hip arthroplasty were compared. MATERIALS AND METHODS: Forty eight and 49 patients with concurrent bilateral and unilateral hip artrhoplasties who had more than a 17-year follow-up time were selected. At final follow-up, mean ages were 69.1 and 66.7 years old in the bilateral and unilateral groups, respectively. Mean follow-up times were 21.5 and 22.4 years in the bilateral and unilateral groups, respectively. Clinical results were attained using Harris hip score and standardized anteroposterior and lateral view X-rays. RESULTS: The bilateral group had mean Harris scores of 44.3(standard deviation 3.78) preoperatively, and 81.2 (10.75) at final follow-up. For the unilateral group, the mean scores were 46.5(3.27) preoperatively, and 80.1 (12.05) at final follow-up. At final follow-up, an acetabular cup was securely located in 78.9% and 82.8% of the bilateral and unilateral groups, respectively, and all cases showed firm fixation of the femoral stem in both groups. Osteolysis around the cup and stem were found in 26.3% and 31.4% of the bilateral group and 16.6% and 17.1% of the unilateral group, respectively. Polyethylene wear rate was 0.17 mm/yr and 0.16 mm/yr in the unilateral and bilateral groups, respectively. Using the Kaplan-Meier method, 17-year survival rates for cup and stem were 78% and 89% in the bilateral group, respectively, and 78% and 86% in the unilateral group, respectively. CONCLUSION: In 17-year long-term follow-up, concurrent bilateral hip arthroplasty was insignificantly different clinically and radiologically from the result of unilateral hip arthroplasty.
Arthroplasty ; Follow-Up Studies ; Hip ; Humans ; Osteolysis ; Polyethylene ; Survival Rate

OBJECTIVE: In a rabbit model using hysteroscopy-guided inoculation of E.coli with antibiotic administration, we determine the effects of persistent intrauterine infection on perinatal outcome including fetal death, congenital sepsis, and abnormal fetal-placental growth and amniotic fluid volume in live fetuses. METHODS: Rabbits with timed pregnancies underwent hysteroscopy at 20 to 21 days of gestation(70%). Animals were inoculated with E. coli (0.2 ml containing 10 cfu/ml) and administered ampicillin-sulbactam(100 mg/kg/day; Unasyn; Pfizer) every 8 hours beginning 30 minutes after microbial inoculation until they were killed 5 days after hysteroscopy. In the first study, the following outcome parameters were evaluated between fetuses with and without pe#rsistent intrauterine infection: fetal survival, congenital sepsis, maternal morbidity, and placental pathology. In second study was performed in 16 rabbits having only both live fetuses with and without persistent intrauterine infection in a rabbit simultaneously. We evaluate the effects of persistent intrauterine infection on fetal-placental weight and amniotic fluid volume in live fetuses. RESULTS: 1) Fetuses with persistent intrauterine infection had significantly fewer live fetuses, more positive cord blood cultures than those without (live fetuses: 44% vs 82%, p<0.000001; positive cord blood cultures: 44% vs 3%, p<0.000001, respectively; Fishers exact test). However the rates of maternal morbidity and placental inflammatory lesions were similar between the two groups. 2) The placental weight and amniotic fluid volume were significantly less in live fetuses with than in those without persistent intrauterine infection. Moreover the fetal weight was decreased in live fetuses with persistent intrauterine infection, but it was not statistically significant(placental weight: p<0.05; amniotic fluid volume: p<0.05; fetal weight: p 0.051, respectively; Wilcoxon matched-pairs signed ranks test). CONCLUSION: Fetal complications including fetal death, congenital sepsis, and decreased fetal-placental weight and amniotic fluid volume wae produced in utero when pasistent intrauterine infection was present with antibiotics administration after inoculstion of E. coli. Therefore, when treating with antibiotics in intrauterine infection, it is needed to observe and monitar the presence of persistent intrauterine infection, and if it is peristent, delivery may be considered for the improvement of pregnancy outcome.
Amniotic Fluid ; Animals ; Anti-Bacterial Agents ; Female ; Fetal Blood ; Fetal Death ; Fetal Weight ; Fetus ; Hysteroscopy ; Obstetric Labor, Premature ; Pathology ; Pregnancy ; Pregnancy Outcome ; Rabbits ; Sepsis