STUDY DESIGN: The authors analysed the recovery of clinical symptoms after percutaneous drainage and irrigation in pyogenic vertebral osteomyelitis. OBJECTIVES: To determine the role of percutaneous drainage and irrigation in pyogenic vertebral osteomyelitis. SUMMARY OF LITERATURE REVIEW: Pyogenic vertebral osteomyelitis is a relatively rare condition but its incidence is recently increasing due to common use of intravenous access devices and resultant nosocomial bacteremia. Management of the disease is not uniform and is controversial regarding the role of surgery and duration of use of antibiotics. At present, the role of percutaneous drainage of involved spines in treatment of pyogenic vertebral osteomyelitis is not well-known. MATERIALS AND METHODS: We report 3 cases of pyogenic vertebral osteomyelitis which were treated by continuous drainage with automated percutaneous lumbar discectomy device(APLD device) and draining tube after they haute failed to conservative treatment. APLD device, fluoroscopic guide, contrast media and continuous percutaneous draining tubes were used for this procedure. The percutaneous draining tubes were maintained for 7 to 11 days and each case was followed up for 6 to 10 weeks under admission. RESULTS: Symptoms were relieved 3 to 5 weeks after this procedure. The patients were followed up to 12 to 39 months and experienced no recurrence. CONCLUSIONS: Percutaneous drainage and irrigation with APLD device brought prompt and marked clinical recovery. It is indicated as a supplementary method to conservative treatment or in case of high operative risk patient due to poor general conditions. It has minimal invasiveness, short clinical course and low recurrence rate.
Anti-Bacterial Agents ; Bacteremia ; Contrast Media ; Diskectomy ; Drainage* ; Humans ; Incidence ; Osteomyelitis* ; Recurrence ; Spine

Cutaneous metastases from internal carcinornas are relatively rare. The frequency of metastases to the skin varies from 0.5-4.4%. We report a case of cutaneous metastasis suspected to originat from stomach cancer. A 44-year-old female, who had an episode of total gastrectony under diagnosis of stornach cancer three years ago, had multipe painless erythernatous nodules on the case and neck for one year. Histologic findings shows atypical anaplastic cell infiltration at the derr is and subcutaneous tissues. Cells with hyperchrornatic and erally displaced nuclei were recogniz d PAS staining shows positive reactions within the cells of glarid like structure. She died twelve month after the appearance of the cutaneous lesions.
Adult ; Diagnosis ; Female ; Humans ; Neck ; Neoplasm Metastasis* ; Skin ; Stomach Neoplasms ; Stomach* ; Subcutaneous Tissue

BACKGROUND: Diabetes mellitus is a heterogeneous group of disorders characterized by high serum glucose levels and by disturbances of carbohydrate and lipid metabolism. There are many cutaneous signs of this common endocrinopathy, such as nercobiosis lipoidica diabeticorum, diabetic bullosis, shin spot, diabetic pruritus, etc. OBJECTIVE: In this study, we investigated whether extracellular matrix gene expression in cultured skin fibroblast is influenced by insulin and Insulin-like growth factor-I(IGF-I). METHOD: Total RNA was isolated from insulin or IGF-I treated human skin fibroblasts. The Northern blot and slot-blot hybridization were then conducted. RESULTS: The mRNA levels of pro α1(I) collagen, pro α1(I11) collagen, fibronectin in insulin and IGF-I treated normal skin fibroblasts increased compared with untreated normal skin fibroblasts. CONCLUSION: Our results show that insulin and IGF-I stimulate collagen formation in normal skin fibroblast at physiological concentrations. Therefore, these demonstrate that insulin can modulate the expression of extracellular matrix gene.
Blood Glucose ; Blotting, Northern ; Collagen ; Diabetes Mellitus ; Extracellular Matrix* ; Fibroblasts* ; Fibronectins ; Gene Expression ; Humans ; Insulin* ; Insulin-Like Growth Factor I ; Lipid Metabolism ; Methods ; Pruritus ; RNA ; RNA, Messenger ; Skin*

No abstract available.
Aneurysm, False*

No abstract available.
Posterior Cruciate Ligament* ; Tendons*

BACKGROUND: The diagnostic significance of ECG ergonovine test and the incidence of vasospastic angina in patients with chest pain are still uncertain. METHODS: From May 1998 to June 1999, 133 consecutive patients with chest pain were admitted for diagnostic coronary angiography. ECG ergonovine provocation tests were performed in 64 patients who have a clinical history suggesting vasospatic angina, including 27 of 28 patients with vasospastic angina documented electrocardiographically, or who's coronary angiographic findings could not be explained by their clinical history. Ergonovine was administered intravenously in incremental dose of 0.05, 0.1, 0.2, 0.3, 0.4 mg up to total cumulative dosage of 1.0mg during coronary angiography(41 cases), in the exercise laboratory(21 cases) or both(2 cases). RESULTS: Of 133 patients with chest pain, vasospastic angina was documented in 32(24%), unstable angina in 52(34%), stable angina in 10(8%), and others in 39(29%). Angiography demonstrated coronary spasm in 4 additional patients as well as 22 patients with vasospastic angina documented electrocardiographically, but ergonovine tests in the exercise laboratory showed positive response in 5 of 6 patients with vasospastic angina documented. Among the 25 patients with coronary spasm proved angiographically during ergonovine test, ECG findings at the time of coronary spasm were ST segment elevation in 21(84%), depression in 1(4%) and no change in 3(12%) patients, who had branch vessel spasm, 3 vessel spasm or incomplete spasm on coronary angiogram. Of the 31 patients with vasospastic angina who underwent ergonovine tests, positive response occurred in 24(77%) after a cumulative dose of < or = 0.4mg and in additional 3(10%) after the higher dose of >0.4mg. However the other 4(13%) had no ECG changes even after the higher dose(>0.4mg) of ergonovine. CONCLUSION: This results suggest that vasospastic angina appear to be a common cause of chest pain, and ECG ergonovine test with high dose can improve diagnostic sensitivity but cannot detect some patients with vasospastic angina.
Angina, Stable ; Angina, Unstable ; Angiography ; Chest Pain ; Coronary Angiography ; Depression ; Electrocardiography* ; Ergonovine* ; Humans ; Incidence ; Spasm

Ecthyma Gangrenosum is a rapidly progressing skin infection charact,erized by edema, hemorragic bullae and necrosis. Ecthyma Gangrenosum occurs almost exclusively in severely imrnunocompromised patients during the course of pseudomanas aeruginosa septisemia. A 5 month-old boy was transferred to our department because of multiple well defined central necrotic black-colored large erythematous bullae. In the bacterial cultures of skin, stool and liver aspiration fluid, Pseudomonas aeruginosa was grown. In the abdominal ultrasonogram and computed tomogram, the multiple liver abscess, hepatomegaly and ascites were shown on both hepatic lobes. Herein we report a case of ecthyma gangrenosum associated with liver abscess.
Ascites ; Ecthyma* ; Edema ; Hepatomegaly ; Humans ; Infant ; Liver Abscess* ; Liver* ; Male ; Necrosis ; Pseudomonas aeruginosa ; Skin ; Ultrasonography

An 41-year-old woman with chronic active hepatitis developed multible asymptomatic erythematous papules, plaques and purpuras on the both lower leg, feet, forearms and hands. Some lesions progressed to ulcers with central black colored necrotic eschars. Biopsies and cultures demorrstrated a fungus, aspergillus fumigatus a the etilogic agent. No evicience of involvement of other organs by aspergillus fumigatus was found. Intravenous amphotericin B therapy was discontinued because of he immediate adverse effects. The patient received treatment with oral itaconazole(200mg/day) and intravenous fluconazole(400mg/day), but skin lesions have been recurring repeatedly.
Adult ; Amphotericin B ; Aspergillosis* ; Aspergillus fumigatus ; Biopsy ; Female ; Fluconazole ; Foot ; Forearm ; Fungi ; Hand ; Hepatitis* ; Hepatitis, Chronic ; Humans ; Leg ; Purpura ; Skin ; Ulcer

This study was carried out to investigate the light and electron microscopic findings of the livers of rats after an intraperitoneal injection of cadmium chloride. The Sprague-Dawley rats were intraperitoneally injected with cadmium chloride dissolved in water, once a day for three days. These animals were sacrificed at 1, 3, 8, and 24 hr after the last injection. Control groups of the rats were also sacrificed in the same manner. The liver was extirpated and examined by both light and electron microscopy. The results obtained are as follows: The parenchyma of the liver shows focal neutrophilic infiltration and spotty necrosis. The hepatocytes show fatty change, ballooning degeneration, swelling of the endoplasmic reticulum and mitochondria, increase numbers of secondary lysosomes and residual bodies. Focal patic venules and sinusoids of the liver are congested. The Kupffer cells are increase in number. Therefore, it can be concluded that the cadmium is directly acted to hepatocytes resulting in cellular injuries and deposits in the fat droplets of the cytoplasm of the hepatocytes, not Ito cells as previously suggeted.
Rats ; Animals

No abstract available.
Animals ; Cloning, Molecular* ; Interleukin-2* ; Mice*