Pyogenic osteomyelitis is at times tragic disease from which severe deformity and disability may result. The incidence and mortality rate of pyogenic osteomyelitis have decreased strikingly since penicillin became available for general use in the treatment of pyogenic osteomyelitis in 1944 and had a dramatic effect. Recently, since the use of new antlblotics, the effect of treatment has been expected in Pyogenic osteomyelitis. But causative organisms of pyogenic osteomyelitis was gradually increasing in resistance to antibiotics. There is also a trend of gradual increase of pyogenic osteomyelltis due to Gram negative bacilli. The author has been analysed 134 patients on whom followup was observed for a minimum of six months at the Department of Orthopedic Surgery of Hanyang University from May, 1972 to December, 1978. The results were as follows: 1. The incidence of pyogenic osteomyelitis is a trend of gradual increase with 14.2% in 1973, 15.7% in 1975 and 26.9% in 1978. 2. Sex ratio was 2.6: 1 (Male: Female): Age distribution showed the group between 5 and 15 years old was 20 patients(62.5%) in acute osteomyeIitis, and the group between 15 and 30 years oId was 52 Patients (51%) In chronic osteomyelitis. 3. The order of involved bones is femur(41%), tibia(27.8%) and humerus(10.4%). 4. Erythrocyte sedimentation rate was remarkably increased in 92.8% of male and 86.5% of female. 5. The causative organism was mostly staphylococcus aureus(84%) in acute osteomyelitis, and Staphylococcus aureus(44.8%), mixed organisms(20.9%) and Gram negative, bacilli(8.3%) in chronic osteomyelitis. Especially, mixed cases with Staphylococcus aureus and Gram negative bacilli contain 55% of mixed organisms. 6. Penicillin was most resistant (79.7%) to Staphylococcus aureus. Cloxacillin was most susceptable (91.3%) to Staphylococcus aureus. 7. The treatment of acute osteomyelitis showed arrest(72.7%) in case of massive antibiotics by early finding of clinical symptom, but if clinical symptoms were not improved within 48 hours with the use of antibiotics, early decompression was done and was arrested(84.6%) in acute osteomyelitis. Closed continuous irrigatlon with saucerization was done and was arrested(85.7%) in chronic osteomyelitis.
Age Distribution ; Anti-Bacterial Agents ; Blood Sedimentation ; Clinical Study ; Cloxacillin ; Congenital Abnormalities ; Decompression ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Mortality ; Orthopedics ; Osteomyelitis ; Penicillins ; Sex Ratio ; Staphylococcus ; Staphylococcus aureus

By Enzinger and Weiss classification, 664 cases of soft tissue tumors, which were confirmed histologically at the department of pathology of Hangang Sacred Heart Hospital from Janusry 1979 to December 1988, were analyzed statistically. The results were as follows : 1. Of the 664 cases, 261 cases (39.3%) were consulted at the Department of General Surgery, 124 cases (18.7%) were consulted at the Department of Orthopedic Surgery, 115 cases (17.3%)were consulted at the Department of Dermatology. 2, Of the 664 cases, 631 cases (95%) were benign and 33 cases (5%) were malignant. 3. The most common benign tumor was lipoma, which was followed by hemangioma and lymphangioma. Among malignant tumors liposarcoma was the most common one, followed by malignant fibrous histiocytoma. 4. The distribution of age of benign tumor was relatively even from childhood to old age but that of malignant tumor showed highest prevalence in 7th decade. 5. The distribution of sex of benign tumor showed male to female ratio of 1: 1.1 but that of malignant tumor showed male to female ratio of 1.5: l. 6. The predilection sites of benign tumors were head, neck and trunk, but those of malignant tumors were lower extremities and trunk. 7. Kinds of soft tissue tumors consulted at the Department of Dermatology were hemangioma, neurofibroma, lipoma, dermatofibroma, ymphangioma, leiomyoma, juvenile xanthogranuloma, xanthoma, keloid and neurilemmoma.
Classification ; Dermatology ; Female ; Head ; Heart ; Hemangioma ; Histiocytoma, Benign Fibrous ; Histiocytoma, Malignant Fibrous ; Humans ; Keloid ; Leiomyoma ; Lipoma ; Liposarcoma ; Lower Extremity ; Lymphangioma ; Male ; Neck ; Neurilemmoma ; Neurofibroma ; Orthopedics ; Pathology ; Prevalence ; Xanthogranuloma, Juvenile ; Xanthomatosis

Technology for the long-term preservation of gamete and embryo has improved greatly over the past 20 years and currently is used for supporting various assisted reproductive technologies (ART). Recent progress in cryobiology and its related sciences have made it possible to preserve human embryos effectively, and several cryopreservation methods also have been developed. Successful freezing of supernumerary embryos has allowed patients undergoing ART the opportunity to achieve pregnancies from more than one embryo transfer without being subjected to controlled ovarian hyperstimulation and oocyte retrieval each time. It also allows a delay in embryo transfer where certain adverse conditions exist for fresh transfer, e.g. when the patient is at risk for ovarian hyperstimulation syndrome or when there is poor endometrial development during the retrieval cycle. Cryopreservation of all available embryos from retrieval is utilized when an oocyte recipient is not properly synchronized with oocyte donor's cycle. In this paper is to review the current status and perspectives of embryo cryopreservation in ART program. Also, briefly discuss the oocyte cryopreservation for the establishment of ovum bank.
Cryopreservation* ; Embryo Transfer ; Embryonic Structures* ; Female ; Freezing ; Humans* ; Oocyte Retrieval ; Oocytes ; Ovarian Hyperstimulation Syndrome ; Ovum ; Pregnancy ; Reproductive Techniques, Assisted

PURPOSE: There are a few reports in the literature that deal with the results of total knee replacement arthroplasty in young rheumatoid arthritis patients. This study was undertaken to evaluate the results of total knee replacement arthroplasty in rheumatoid arthritis patients under the age of 45 years. MATERIALS AND METHOD: Between 1989 and 1993, 43 total knee replacement arthroplasties were performed in 26 adults with rheumatoid arthritis. The age at operation ranged from 23 to 45 years old (average 36.3 years). Of these, four patients (six knees) were lost to follow-up, so 37 knees in 22 patients were available for the follow-up evaluation at a mean 7.8 years (5-8.9). RESULTS: Preoperative flexion contracture was found in 33 knees (89.2%) among 37 knees and it was corrected by operation from 33.1 to 2.6 postoperatively. So the range of motion also improved by an average of 25.6 compare with preoperative state. At the time of final follow-up, six patients were free of pain and 15 patients had mild pain during weight-bearing state, but one patient, with loosening evidence complained of occasional moderate pain. The American Knee Society knee score was improved from a mean of 37.9 points preoperatively to 84.9 points postoperatively. There were 22 excellent, 14 good and one poor (loosening case) results. All patients were able to walk after the operation from 11 non-ambulators and 11 ambulators, assisted with a walking device in preoperative state. The average functional score also improved from 11.9 points to 86.8 points. Radiographic evaluation revealed a radiolucency rate of 43.2%, and revealed radiolucent line adjacent to 3 femoral and 15 tibial components. Almost all of the patients (91%) were satisfied with the result of operation, subjectively. Only one patient had a revision because of subsidency and loosening of a tibial prosthesis. CONCLUSIONS: We considered that total knee replacement arthroplasty for patients with rheumatoid arthritis and was less than 45 years old provided satisfactory and effective results.
Adult ; Arthritis, Rheumatoid* ; Arthroplasty* ; Arthroplasty, Replacement, Knee* ; Contracture ; Follow-Up Studies ; Humans ; Knee ; Lost to Follow-Up ; Middle Aged ; Prostheses and Implants ; Range of Motion, Articular ; Walking ; Weight-Bearing

Brachiocephalic venous aneurysm (BVA) development is an extremely rare, particularly as a primary vascular disorder. BVAs may be misinterpreted as lymphadenopathies owing to the variable degrees of enhancement seen in imaging studies, especially among patients with underlying malignancy. We report a BVA that mimicked lymph node metastasis on CT in a 60-year-old female who had undergone subtotal gastrectomy for stomach cancer. After followup chest CT with different bolus times and Doppler ultrasonography, a venous aneurysm originating from the brachiocephalic vein was diagnosed. We emphasize that, to make an accurate diagnosis, physicians should be aware of the potential diagnostic pitfalls and have a high index of suspicion for BVA when encountering certain lesions in the cervical area.

The ankle is a complex, weight bearing joint consisting of tibia, fibula, talus, and many soft tissue structures, which play an important role biomechanically. The injuries to the ankle joint include not only fractures of bone but significant injuries of ligaments and other soft tissues. It is very important to understand the mechanisms of trauma in order to make definite diagnosis and proper treatment. The author' analysed 127 eases(126 patients) of the ankle fractures which were admitted and treated in Orthopaedic Department,Hanyang University Hospital from January 1978 to December 1985. The results obtained from this study were as follows: 1. Of the 127 cases, male was 90 cases(70.87%), female was 37 cases(29.13%), and average age of the patients was 37.6 years. 2. Open fractures were 12 cases(9.4%) and closed fractures were 115 cases(90.6%). 3. According to the classification of Lauge-Hansen, the most common type of the ankle fracture was supination-external rotation type (35.43%). 4. Of the 127 cases, 63 cases were treated by closed reduction and 64 cases by open reduction. 5. The average period of the cast immobilization after open reduction was 7.8 weeks, where as that of closed reduction was 10.5 weeks. 6. According to clinical and radiological assessment of the result of the treatment, open reduction was better than closed reduction. 7. The best result of the treatment was noticed in supination-adduction type, according to the classification of Lauge-Hansen. 8. Accurate reduction and rigid internal fixation of the fractured lateral malleolus and distal fibuIa was important in treatment of the ankle fracture.
Ankle Fractures ; Ankle Joint ; Ankle ; Classification ; Clinical Study ; Diagnosis ; Female ; Fibula ; Fractures, Closed ; Fractures, Open ; Humans ; Immobilization ; Joints ; Ligaments ; Male ; Talus ; Tibia ; Weight-Bearing

Peripheral neuropathies occur in lymphoma patients. Causes of neuropathy include chemotherapy, opportunistic infections, and the lymphoma itself. We report a patient with lymphoma whose chief complaint was a sensory loss in the hands and feet. Electrophysiologic studies and sural nerve biopsy showed sensory polyneuropathies. We hypothesize that this neuropathy is associated with lymphoma-related ganglionopathy, and among the possible causes, we suspect that a systemic cause such as a paraneoplastic syndrome is the most likely pathogenic etiology. However, further follow-up will be necessary to see whether sensory symptoms change with lymphoma treatment.
Adult ; Biopsy ; Electrophysiology ; Hodgkin Disease/*complications/*diagnosis ; Human ; Lymphatic Metastasis ; Lymphoma/*metabolism ; Male ; Peripheral Nervous System Diseases/*complications/*pathology ; Sensation Disorders/complications/pathology

BACKGROUND: Free radical-mediated oxidative damage has been implicated in ischemic brain injury. There are also increasing evidences that nitric oxide is involved in the mechanisms of cerebral ischemia. To elucidate the effect of nitric oxide synthesis inhibition on the hydroxyl radical formation, we used a method based on the chemical trapping of hydroxyl radical in the form of the stable adducts 2,3-DHBA following salicylate adminstration. METHODS: Sprague-Dawley rats were subjected to 15 min of global cerebral ischemia by both carotid artery occlusion plus systemic hemorrhagic hypotension (35 mmHg). Artificial CSF including salicylate (5 mM) was continuously infused through a microdiaysis probe implanted in the left hippocampus CA1. Hippocampal extracellular fluid was sampled at regular intervals before, during, and after ischemia. The levels of 2,3-DHBA were assayed by HPLC with electrochemical detection during 15 minutes of ischemia and reperfusion period. RESULTS: Cerebral blood flow was reduced to 5% level of control in ischemic period, but increased 3 or 4 times in early phase of reperfusion period, and returned to normal 50 to 60 minutes after the cessation of ischemia. Inhibition of NOS by L-NAME did not prevent ischemia-induced 2,3-DHBA elevation, but increased its level during reperfusion. This increase in 2,3-DHBA could be reversed by L-arginine. The elevated 2,3-DHBA after IR in L-NAME treated rats was not due to either changes in CBF or local blood brain barrier permeability. CONCLUSIONS: The above results indicate NO protects brain from damages by hydroxyl radical, at least less than one hour after initiation of reperfusion.
Animals ; Arginine ; Blood-Brain Barrier ; Brain ; Brain Injuries ; Brain Ischemia ; Carotid Arteries ; Chromatography, High Pressure Liquid ; Extracellular Fluid ; Hippocampus ; Hydroxyl Radical* ; Hypotension ; Ischemia ; NG-Nitroarginine Methyl Ester ; Nitric Oxide Synthase* ; Nitric Oxide* ; Permeability ; Rats* ; Rats, Sprague-Dawley ; Reperfusion

Unlike typical hydroa vacciniforme (HV), Epstein-Barr virus (EBV)-associated HV-like eruption is more variable in its clinical manifestations. In some patients, progression to lymphoma or leukemia has been reported, which are characterized by the T-cell immunophenotype. Here, we report the first Korean case of EBV-associated vesiculopapular eruption on the face of a patient with natural killer (NK)/T cell lymphoma. A 32-year-old Korean man presented with a late adolescent-onset recurrent necrotic papulovesicles on his face. The patient was previously diagnosed with EBV-associated NK/T cell lymphoma of the oral cavity and also had childhood-onset hypersensitivity to mosquito bites. Biopsy of his facial skin showed EBV-associated vesiculopapular eruptions, though ultraviolet provocation did not reproduce the skin lesions. EBV viral load in his peripheral blood was detected but low. The patient was treated with systemic chemotherapy. The lymphoma went into remission, but the facial EBV-associated vesiculopapular eruption had a relapsing and remitting course.
Adult ; Biopsy ; Culicidae ; Drug Therapy ; Herpesvirus 4, Human ; Humans ; Hydroa Vacciniforme ; Hypersensitivity ; Leukemia ; Lymphoma* ; Mouth ; Natural Killer T-Cells* ; Skin ; T-Lymphocytes ; Viral Load

We present a 55-year-old man who has a six-month history of progressive weakness of all limbs. Findings from neurologic examination were notable for a diffuse muscular weakness and atrophy in all limbs. Laboratory findings for collagen vascular disease, monoclonal gammopathy, and infections were normal. Electrophysiologic studies supported lower motor neuron (LMN) syndrome. CT scan and needle biopsy disclosed small cell lung cancer. This case suggests that in some elderly patients with LMN syndrome a careful search for an underlying cancer is warranted.
Aged ; Atrophy ; Biopsy, Needle ; Collagen ; Extremities ; Humans ; Lung Neoplasms ; Middle Aged ; Motor Neuron Disease ; Motor Neurons* ; Muscle Weakness ; Neurologic Examination ; Paraneoplastic Syndromes ; Paraproteinemias ; Small Cell Lung Carcinoma ; Tomography, X-Ray Computed ; Vascular Diseases