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

The most important spinal disorders in childhood are malformations and mass lesions. High-resolution, real-time ultrasonography of the spine enables the differentation of intraand paraspinal structures in a significant way. This examination does not require sedation, does not use radiation, can be performed in the nursery or an incubator and is less expensive than computed tomography or magnetic resonance imaging. The sonographic appearence of the various kinds of spinal dysraphism is demonstrated and illustrated. Based on our preliminary experience spinal sonography appears to be useful in neonates and infants as the first imaging device for differentiation of cmplex malformation and as a screeing method for occult spinal dysraphism.
Humans ; Incubators ; Infant* ; Infant, Newborn* ; Magnetic Resonance Imaging ; Neural Tube Defects ; Nurseries ; Spinal Dysraphism* ; Spine ; Ultrasonography*

Primary pericardial tumors are rare than those originating within the myocardium or endocardium and, moreover, primary benign pericardial tumors are much rare in occurrence. Fine(1986) was able to collect only 43 cases of lipoma. Most cases are diagnosed only at autopsy. One fourth of the cardiac lipoma arise subepicardially, where they suggest the presence of pericardial effusion with compression or displacement of the heart. A case of primary intrapericardial lipoma simulating pericardial effusion is presented. This tumor originated in left anterior aspect of pericardium. The tumor was measured 30x30x5cm in size and 2,200mg in weight. Total excision of the mass was accomplished by posterior lateral thoracotomy incision, resulting in complete cure. This is the first case of primary benign lipoma of the pericardium in literatures in our knowledge.
Autopsy ; Endocardium ; Heart ; Lipoma* ; Myocardium ; Pericardial Effusion* ; Pericardium ; Thoracotomy

No abstract available.
Ankle Fractures* ; Ankle*

No abstract available.
Myocutaneous Flap* ; Pressure Ulcer*

BACKGROUND: Recently doubts have been raised regarding the diagnostic significance of some of the minor clinical features of atopic dermatitis (AD) proposed by Hanifin and Rajka. Some of them may be nonspecific and racial difference was suggested. OBJECTIVE: The purpose of this study is to evaluate the diagnostic significance of 14 minor clinical features out of Hanifin and Rajka's 23 minor features of AD in the Korean pediatric population. The significance of 5 more items was evaluated as additional minor features. METHODS: The difference in frequency of the total 19 features of AD was compared between 100 patients with AD and 76 controls. RESULTS: Fourteen of these were shown to be significantly more frequent in patients than in controls including our 5 additional clues such as scalp scaling, postauricular fissure, infraauricular fissure, forehead lichenification, and infragluteal eczema. CONCLUSION: Our study about the minor features may be a valuable guideline for the diagnosis of AD in the Korean pediatric population.
Dermatitis, Atopic* ; Diagnosis ; Eczema ; Forehead ; Humans ; Scalp

BACKGROUND: Recently doubts have been raised regarding the diagnostic significance of some of the minor clinical features of atopic dermatitis (AD) proposed by Hanifin and Rajka. Some of them may be nonspecific and racial difference was suggested. OBJECTIVE: The purpose of this study is to evaluate the diagnostic significance of 14 minor clinical features out of Hanifin and Rajka's 23 minor features of AD in the Korean pediatric population. The significance of 5 more items was evaluated as additional minor features. METHODS: The difference in frequency of the total 19 features of AD was compared between 100 patients with AD and 76 controls. RESULTS: Fourteen of these were shown to be significantly more frequent in patients than in controls including our 5 additional clues such as scalp scaling, postauricular fissure, infraauricular fissure, forehead lichenification, and infragluteal eczema. CONCLUSION: Our study about the minor features may be a valuable guideline for the diagnosis of AD in the Korean pediatric population.
Dermatitis, Atopic* ; Diagnosis ; Eczema ; Forehead ; Humans ; Scalp

No abstract available.
Humans

No abstract available.
Rectal Prolapse* ; Surgical Procedures, Operative*

The Diltiazem hydrochloride is a new calcium antagonist of which effect on angina pectoris has been reported. Authors studied the clinical effect of Diltiazem in 18 cases of angina pectoris including stable and unstable angina. The 14 cases were male and 4 cases were female with ages ranging 46 to 72 years. All cases had typical anginal attack on 1-6 times in everyday with transient improvement by sublingual nitroglycerin. After coutine physical and laboratory work-up, Diltiazem 30mg tablet was given 3 times a day for 3 consecutive weeks and checked the response of angical pain for first 3 times visit with 3 days interval and thereafter with one week interval. In 13 cases of 15 cases, the Diltiazem alone was medicated. There was considerable improvement of anginal attack in 13 cases of 15 cases with Diltiazem alone, namely complete subsidence of anginal attack throughout 3 weeks in 2 cases, only minimal substernal discomfort on effort once a week in 4 cases and in 7 cases the frequency and severity of anginal pain reduced to about 50% of control state. In 2 of 15 cases there were no effect on anginal pain until one week, subsequently a beta-blocker was added and the anginal attack improved considerably in both cases. In 3 cases of 18 cases, the anginal attacks were so severe and frequent that the Diltiazem with beta-blocker were given from the beginning. In one case the anginal pain disappeared completely and in two cases there were good effect. The effect of Diltiazem usually started to occurs in 3 days to one week after medication. The overall effectiveness of Diltiazem in angina pectoris was 87% with excellent effect in 40%, good effect in 27% and fair effect in 20%. In 5 cases of good response to Diltiazem, the stress exercise test by bicycle ergometer was carried out before and after one week medication with programs of 30 wt, 50 wt, 75 wt, and 100 wt loading for 4 minutes in each stage. The exercise tolerance improved about 25-50 wt, the ST depression by exercise became less by 1-2mm and the maximal heart rate increased by 4-9/min. These data showed marked improvement of exercise tolerance in angina pectoris by Dltiazem objectively. There were macular skin rash, diarrhea and mild dizziness in one case respectively which were improved without treatment. These data showed that Diltiazem was highly effective in angina pectoris except few very severe cases. In severe cases, the combined therapy of Diltiazem and beta-blocker was more effective.
Angina Pectoris* ; Angina, Unstable ; Calcium ; Depression ; Diarrhea ; Diltiazem* ; Dizziness ; Exanthema ; Exercise Test ; Exercise Tolerance ; Female ; Heart Rate ; Humans ; Male ; Nitroglycerin