In 1868 Charcot described the join in tabes dorsalis, which since then has been designated as Charcot neuroarthropathy. It is characterized by painless swelling and abnormal mobility of the affected joint. Arthropathy of the type described by Charcot has been associated with various other conditions, such as diabetes mellitus, syringomyelia, injury to nerve root, congenital indfference to pain, leprosy, and intra-articular use of steroid, etc. Authors present a case of Charcot joint which involved the left knee joint associated with pathologic fracture of the left tibia and fibula.
Arthropathy, Neurogenic ; Diabetes Mellitus ; Fibula ; Fractures, Spontaneous ; Joints ; Knee Joint ; Knee ; Leprosy ; Syringomyelia ; Tabes Dorsalis ; Tibia

Tarsometatarsal injury has not been paid much attention due to it is unusual frequency. But the cases of tarsometatarsal injuries are on the increase in proportion to the increasing "high energy trauma injury" resulted from the traffic and industrial accidents. The purpose of this study is both assessing the relative effects among clinical results, final radiologic findings, treatment results and symtoms. In view of the results so far achieved from 20 cases of tarsometatarsal fracture dislocation which had been treated at Sung-Ae general hospital from January 1990 to December 1993, the results were as follows: 1. Thirteen cases were treated by open reduction and 3 cases were treated by closed reduction with smooth pins but no reduction loss were experienced. 2. Traumatic arthrosis could be observed in 14 cases but there were no influences on the functional end results. 3. Anatomical results correlated with pain. 4. Anatomical or neraly anatomical reduction was considered as most important factor of prognosis.
Accidents, Occupational ; Dislocations ; Hospitals, General ; Prognosis

Emphysematous pyelonephritis is a rare complication of severe acute pyelonephritis and a suppurative infection of the renal parenchyma characterized by the production of gas by bacteria through fermentation. Emphysematous pyelonephritis occurs in patient with diabetes mellitus or urinary obstruction. We review the diagnosis and management of emphysematous pyelonephritis and report a case of emphysematous pyelonephritis developed in renal tuberculosis.
Bacteria ; Diabetes Mellitus ; Diagnosis ; Fermentation ; Humans ; Pyelonephritis* ; Tuberculosis, Renal

True hermaphroditism. in which both ovarian and testicular tissue are found in the same individual, is a rare disease. Recently the authors have seen a case of true hermaphroditism who had a testis on the right gonad and an ovotestis on the left gonad with a karyotype of 46 XX, and report this case here with a brief review of the literature.
Disorders of Sex Development ; Gonads ; Karyotype ; Ovotesticular Disorders of Sex Development* ; Rare Diseases ; Spermatic Cord Torsion* ; Testis

No abstract available.
Vascular System Injuries

Oak tree death caused by symbiosis of an ambrosia beetle, Platypus koryoensis, and an ophiostomatoid filamentous fungus, Raffaelea quercus-mongolicae, has been a nationwide problem in Korea since 2004. In this study, we surveyed the yeast species associated with P. koryoensis to better understand the diversity of fungal associates of the beetle pest. In 2009, a total of 195 yeast isolates were sampled from larvae and adult beetles (female and male) of P. koryoensis in Cheonan, Goyang, and Paju; 8 species were identified by based on their morphological, biochemical and molecular analyses. Meyerozyma guilliermondii and Candida kashinagacola were found to be the two dominant species. Among the 8 species, Candida homilentoma was a newly recorded yeast species in Korea, and thus, its mycological characteristics were described. The P. koryoensis symbiont R. quercusmongolicae did not show extracelluar CM-cellulase, xylanase and avicelase activity that are responsible for degradation of wood structure; however, C. kashinagacola and M. guilliermondii did show the three extracellular enzymatic activities. Extracelluar CM-cellulase activity was also found in Ambrosiozyma sp., C. homilentoma, C. kashinagacola, and Candida sp. Extracelluar pectinase activity was detected in Ambrosiozyma sp., C. homilentoma, Candida sp., and M. guilliermondii. All the 8 yeast species displayed compatible relationships with R. quercus-mongolicae when they were co-cultivated on yeast extract-malt extract plates. Overall, our results demonstrated that P. koryoensis carries the yeast species as a symbiotic fungal associate. This is first report of yeast diversity associated with P. koryoensis.
Adult ; Ambrosia* ; Beetles* ; Candida ; Cellulases ; Chungcheongnam-do ; Fungi ; Humans ; Korea* ; Larva ; Platypus* ; Polygalacturonase ; Quercus* ; Symbiosis ; Wood ; Yeasts*

BACKGROUND: Although the cardiac pump mechanists and the thoracic pump mechanism have been suggested, the mechanism of blood flow generated by precordial compression in human remains controversial. We hypothesized that, during compression systole, the proximal descending thoracic aorta would be distended by forward blood flow if the heart acts as a pump, and be contacted or unchanged if increased intrathoracic pressure generates blood flow. METHODS: Fourteen patients with cardiac angst underwent transesophageal echocardiogaphy to verify the morphologic changes of the descending thoracic aorta during standard manual cardiopulmonary resuscitation. The aortic dimensions including cross sectional area and diameters at the end of compression and of relaxation were measured proximal to and at the maximal compressing site of the descending thoracic aorta. RESULTS: At the point of maximal compression, deformations of the descending thoracic aorta were observed during compression in all patients and ratio of the longest to shortest diameter of the aorta deceased during compression than relaxation(0.58+/-0.15 versus 0.81+/-0.11, p=0.001). Cross sectional area of the aorta at the maxim compression deceased during compression than relaxation(3.01+/-1.91 versus 7.26+/-14.70 cm2, p=0.035). Ratio of the longest to shortest diameter of the proximal descending thoracic aorta remained unchanged during compression and relaxation(1.0+/- 0.88 versus 1.0+/-0.9, p=0.345). Cross sectional area of the proximal descending thoracic aorta increased during compression than relaxation(4.81+/-2.86 versus 4.29+/-2.51 cm2, p=0.011). CONCLUSION: Distention of the proximal descending thoracic aorta and deformation of the aorta at the maximal compression during the compression systole suggests that the heart act as a pump during standard manual cardiopulmonary resucitation in human.
Aorta ; Aorta, Thoracic ; Cardiopulmonary Resuscitation* ; Echocardiography* ; Heart ; Humans ; Relaxation ; Systole

PURPOSE: To evaluate the incidence,. degree, and clinical significance of non-obstructive intrahepatic bile duct di'latation encountered on follow up CT after gastrectomy for gastric carcinoma. MATERIALS AND METHODS: We retrospectively analyzed follow-up abdominal CT of 65 patients who had undergone gastrectomy with truncal vagotomy and subtotal gastrectomy for gastric carcinoma. We classified those patients who showed intrahepatic duct dilatation into non-obstructive or obstructive groups depending on the presence or absence of the lesions obstructing the duct. We also evaluated the incidence, degree and pattern, and appearance time of non-obstructive type of duct dilatation. RESULTS: Non-obstructive and obstructive biliary dilatations were present in 8 cases(12.3%) and 9 cases(13. 8%), respectively. The degree of non-obstructive group was mild in 6 cases(75%) and moderate in 2 cases (25%) who had taken cholecystectomy during the follow up period, and patterns were proportional dilatation of the central and peripheral intrahepatic ducts. It appeared on follow up CT obtained 6 to 12 months after operation in 7 cases and 3.5 months in one case. No statistical significance was noted between the type of surgery and the incidence of non-obstructive dilatation(p>0.05). CONCLUSION: Mild dilatation of the central intrahepatic ducts without evidence of mechanical biliary obstruction can be seen on follow-up CT obtained more than 6 months after gastrectomy for gastric carcinoma, and the incidence is about 12%. We think that this finding is non-obstructive and clinical evaluation is unnecessary.
Bile Ducts, Intrahepatic ; Cholecystectomy ; Dilatation* ; Follow-Up Studies ; Gastrectomy* ; Humans ; Incidence ; Retrospective Studies ; Tomography, X-Ray Computed ; Vagotomy, Truncal

OBJECTIVE: This study examined the psychometric properties of the Korean version of the Children's Revised Impact of Event Scale (CRIES) and its validity as a screening instrument for the post-traumatic stress disorder (PTSD). METHODS: The study population consisted of two samples. The clinical sample consisted of 60 child and adolescent patients from the Department of Neuropsychiatry, Ilsan Paik Hospital, Inje University College of Medicine. The normal sample consisted of 291 students from four schools (primary, middle, and high schools). We administered four self-report questionnaires (the CRIES, Child Reports of Post-traumatic Symptoms [CROPS], State-Trait Anxiety Inventory for Children [STAI-C], and Children's Depression Inventory [CDI]) to 351 children and adolescents after obtaining informed consent from all participants and their parents. RESULTS: The CRIES showed good reliability (Cronbach's alpha for the full scale and subscales ranged from 0.85 to 0.93). The total CRIES score was positively correlated with CROPS, STAI-C, and CDI. Confirmatory factor analysis indicated that a three-factor structure for the CRIES (intrusion, avoidance, and hyper-arousal) had a significantly better fit than a two-factor model (intrusion/hyper-arousal and avoidance). Receiver operating characteristic curve analysis indicated that a cutoff of 26 offered the optimum predictive point. That is, this cutoff maximized the balance between sensitivity (0.88) and specificity (0.85). Using this cutoff, the positive predictive value was 0.86, and the negative predictive value was 0.99. CONCLUSION: These findings imply that the CRIES is a highly accurate diagnostic test in clinical settings.
Adolescent ; Anxiety ; Child ; Depression ; Diagnostic Tests, Routine ; Humans ; Informed Consent ; Mass Screening ; Neuropsychiatry ; Parents ; Psychometrics ; ROC Curve ; Sensitivity and Specificity ; Stress Disorders, Post-Traumatic ; Surveys and Questionnaires

Pathogenic bacteria survive in iron-limited host environments by using several iron acquisition mechanisms. Acinetobacter baumannii, causing serious infections in compromised patients, produces an iron-chelating molecule, called acinetobactin, which is composed of equimolar quantities of 2,3-dihydroxybenzoic acid (DHBA), L-threonine, and N-hydroxyhistamine, to compete with host cells for iron. Genes that are involved in the production and transport of acinetobactin are clustered within the genome of A. baumannii. A recent study showed that entA, located outside of the acinetobactin gene cluster, plays important roles in the biosynthesis of the acinetobactin precursor DHBA and in bacterial pathogenesis. Therefore, understanding the genes that are associated with the biosynthesis and transport of acinetobactin in the bacterial genome is required. This review is intended to provide a general overview of the genes in the genome of A. baumannii that are required for acinetobactin biosynthesis and transport.
Acinetobacter baumannii* ; Bacteria ; Genome ; Genome, Bacterial ; Humans ; Iron ; Multigene Family ; Siderophores ; Threonine