Infections of the face, especially of the medial third or "the danger triangle", are the most frequent primary foci associated with thrombosis of cavernous sinus. Microorganisms entering the facial vein and pterygoid plexus from these sites are easily carried to the sinus through the ophthalmic vein. When the septic thrombosis involves various structures in the sinus, multiple clinical manifestations develop and if appropriate anti-infective therapy is not instituted timely, grave consequences with high mortality is possible. Recently, we experienced such a case. A five-year-old boy had high fever, proptosis, periorbital edema, chemosis and limitation of eye movements. Three days before admission, he had suffered from erythematous swelling spreading over the periorbital area, where simple steroid ointment containing no antibiotics had been applied after a furuncle on the nose had been squeezed. On admission, brain MRI revealed meningeal enhancement, high-signal densities in enlarged right cavernous sinus and narrowing of internal carotid artery. Analysis of cerebrospinal fluid showed bacterial meningitis and the cultures of blood and eye discharge proved to be Staphylococcus aureus. On massive antibiotic therapy, he recovered swiftly without any adverse sequelae. The authors report this case with a warning against wide-spread misuse of steroids and inadequate treatment of the mostly neglected, but once-dreaded minor infections on the face.
Anti-Bacterial Agents ; Brain ; Carotid Artery, Internal ; Cavernous Sinus Thrombosis* ; Cavernous Sinus* ; Cerebrospinal Fluid ; Edema ; Exophthalmos ; Eye Movements ; Fever ; Furunculosis* ; Humans ; Magnetic Resonance Imaging ; Male ; Meningitis, Bacterial ; Mortality ; Nose ; Staphylococcus aureus ; Steroids ; Thrombosis ; Veins

BACKGROUND: The purpose of this study was to investigate the outcomes after fixation using a 3.5-mm locking compression plate (LCP) hook plate for isolated greater tuberosity (GT) fractures of the proximal humerus. METHODS: We evaluated the postoperative radiological and clinical outcomes in nine patients who were followed up at least 1 year with isolated GT fractures. Using the deltopectoral approach, we fixed the displaced GT fragments with a 3.5-mm LCP hook plate (Synthes, West Chester, PA, USA). Depending on the fracture patterns, the hook plate was fixed with or without augmentation using either tension suture or suture anchor fixation. RESULTS: All the patient showed successful bone union. The mean time-to-union was 11 weeks. The radiological and clinical outcomes at the final follow-up were generally satisfactory. The mean visual analogue scale for pain, the University of California at Los Angeles score, the American Shoulder and Elbow Surgeons score, and the subjective shoulder value were 1.4, 30.3, 84.3, and 82.2%, respectively. The mean active forward flexion, abduction, external rotation, and internal rotation of the shoulder were 156.7°, 152.2°, 61.1°, and the 10th thoracic vertebral level, respectively. Only one patient presented with a postoperative complication of shoulder stiffness. The patient was treated through arthroscopic capsular release on the 5th postoperative month. CONCLUSIONS: We conclude that fixation using 3.5-mm LCP hook plates for isolated GT fractures of the proximal humerus is a useful treatment method that provides satisfactory clinical and radiological outcomes.
California ; Elbow ; Follow-Up Studies ; Humans ; Humerus* ; Joint Capsule Release ; Methods ; Postoperative Complications ; Shoulder ; Surgeons ; Suture Anchors ; Sutures

No abstract available.
Stroke*

OBJECTIVE: For the treatment of carotid cavernous fistula(CCF), transarterial detachable balloon occlusion(DBO) is the method of choice. When it has failed to occlude the fistula, various embolization methods are used to treat the fistula. Transvenous embolization through the superior ophthalmic vein(SOV) is another method of treatment. The venous approach through the SOV after surgical dissection and exposure of this vein has been recommended by some delete, but(here) delete delete(an) alternative treatment method by percutaneous puncture of the SOV without surgical dissection(is described). METHODS: A 19-year-old woman admitted to our hospital two months after accident, presented with proptosis, chemosis, occulomotor and abducens nerve palsies, and bruit of the right eye. The authors tried DBO via transarterial route in initial treatment and the fistula was occluded with subsequent disapearance of bruit. However, 2 weeks later, she complained of recurence of bruit. Transarterial approach was attempted again, but the fistula hole was too small for this approach. The venous approach via SOV by percutaneous puncture was then tried. Puncture was made at the medial one third of the superior orbital rim and the fistula was embolized with Guglielmi detachable coils (GDCs). RESULTS: The fistula was completely occluded and no early and late complications noted. The patient's clinical symptoms were improved within a few days. CONCLUSION: Treatment of CCF by percutaneous puncture of the SOV is an alternative and effective method when other approaches are not feasible.
Abducens Nerve Diseases ; Exophthalmos ; Female ; Fistula* ; Humans ; Orbit ; Punctures* ; Veins* ; Young Adult

No abstract available.
Humans ; Infant* ; Mothers* ; Polyhydramnios

No abstract available.
Child* ; Down Syndrome* ; Humans ; Hypothyroidism* ; Incidence*

BACKGROUND: A lots of fires were happened every years. And then, the many peoples have died because of foe. It is important to plane for initial field emergency management that the major cause of death and injury type is analysed by large scaled fire. METHOD: We have analysed the fire victims by large scaled fire from Jan. 1995 to Dec. 1995 in Korea. We analysed systemic factors, environmental factors, patient factors which was acquired from medical records and interviews with victims, victim's famaly, rescuer. RESULT: The total number of victims are 130 and the mortality rate is 61.5% (80 patients). The major injury and cause of death were inhalation injury and trauma. The injury type of fire victims are 19 cases of inhalation injury, 13 cases of laceration,5 cases of burn,5 cases of contusion,4 cases of blephaloconjunctivitis. In fire deaths, the 78 victims (97.5%) were death associated with the gas inhalation, and the only 2 fire deaths were due to trauma. This result of the cause of death was higher inhalation injury than previously reported literature because most fires of our study was happened at the closed-maze area. CONCLUSION: When the fee was happened at closed-maze area, many victims foiled to escape the space because of smoke, toxic inhalants from combustible interior decoration, and then were death.
Cause of Death ; Emergencies* ; Emergency Treatment* ; Fees and Charges ; Fires* ; Humans ; Inhalation ; Korea ; Medical Records ; Mortality ; Smoke ; United Nations

BACKGROUND: The Sampung Collapse took place at 17:55 June 29, 1995. The rescue operation encountered 458 dead and 477 multiply traumatized patients and 464 non traumatized peoples. We wanted to present basic data for disaster planning for example of Sampung Collapse. METHODS: We made a survey of accident field immediately after accident and interviewed with victims, victim's famaly, and rescuer. We analysed the medical record and SCL-9 (Hopkins symptom check list 90R) which was checked several list with victims, victim's family and control group. RESULT: The mean RTS was 11.9 and the mean ISS was 4.3.96 long bone fractures occurred in 76 patients. 127 case of vertebral injury occurred in 63 patients. Total number of surgical operations were 237. There are also many crushing injury and acute post-traumatic stress diseases. CONCLUSION: There are many injury types which are crushing injury, vertebral injury, blunt trauma and acute PTSD(post traumatic stress diseases). Thus, The field management, especially field triage, is very important. And, the urgent patients were 72 patients, about 5% of total patients, witch needed intensive care in tirtiary hospital. Therefore, we need to plan out the expeditious proper management. and prevention of disaster propagation.
Disaster Planning ; Disasters ; Fractures, Bone ; Humans ; Critical Care ; Medical Records ; Triage ; Wounds, Nonpenetrating

Twenty-five patients with spontaneous intracerebellar hematoma were analyzed, who had been admitted to Jeonju Jesus Hospital from 1982 to 1985. All cases were diagnosed by CT scan and the amount of the hematoma was assessed by the largest diameter and the height as large, moderated, and small. Three clinical types were defined to evaluate the method of treatment and the outcome. All twelve acute cases were operated and seven were dead-five from brainstem failure, one from rebleeding, and one from chest infection. All chronic cases were treated conservatively to yield good results. Of seven subacute cases, five were operated and two died. Overall mortality was 36% and surgical mortality was 53%. To avoid considerable loss of potential recovery, it is suggested that prompt confirmation of the intracerebellar hematoma by CT scan, emergency surgical management, proper pre-and post-operative care results in better prognosis in cases of this not-uncommon-not-incurable disease.
Brain Stem ; Emergencies ; Glasgow Outcome Scale ; Hematoma* ; Humans ; Jeollabuk-do ; Mortality ; Prognosis ; Thorax ; Tomography, X-Ray Computed

PURPOSE: To analyze the effects of clinical and laboratory factors, including insulin-like growth factor (IGF) levels, on the height velocity of normal prepubertal children. METHODS: Ninety-five healthy prepubertal children (33 boys, 62 girls) were enrolled. The mean chronological age was 6.3±1.4 years, with a height standard deviation score (SDS) of -0.88±0.70. IGF-1, IGF binding protein-3 (IGFBP-3), SDS for anthropometric measurements, and changes in SDS for anthropometric measurements were analyzed for 1 year, and their associations with 1-year height velocity were investigated. RESULTS: The group of children with a 1-year height velocity of ≥6 cm were chronologically younger than the group with a 1-year height velocity of < 6 cm (5.9±1.3 years vs. 6.7±1.3 years, P=0.004), with a lesser increase of SDS for body mass index (BMI) over 1 year (-0.18±0.68 vs. 0.13±0.53, P=0.014). There were no differences between the 2 groups in IGF-1 SDS and IGFBP-3 SDS. Multiple linear regression showed that baseline chronological age (r=0.243, P=0.026) and height SDS (r=0.236, P=0.030) were positively associated with IGF-1 SDS. Binomial logistic regression showed that an older chronologic age at referral (odds ratio [OR], 0.68; 95% confidence interval [CI], 0.47–0.99) and an increase of BMI SDS over 1 year (OR, 0.41; 95% CI, 0.18–0.89) were associated with a decreased growth possibility of an above-average height velocity (≥6 cm/yr). CONCLUSIONS: Height velocity of normal prepubertal children is affected by an increase of BMI SDS and chronological age. Prepubertal IGF-1 SDS reflects height SDS at the time of measurement but is not associated with subsequent height velocity.
Body Mass Index ; Child* ; Humans ; Insulin-Like Growth Factor Binding Protein 3 ; Insulin-Like Growth Factor I ; Linear Models ; Logistic Models ; Referral and Consultation