No abstract available.
Respiratory System* ; Respiratory Tract Infections*

Acute osteomyelitis is usually shown as a localized area of increased activity (hot uptake) in the infectious focus on bone scintigraphy. In our patient, absence of radioactivity (cold lesion) was noted in the distal metaphyseal and diaphyseal regions of his right femur. Initial x-ray was interpreted as normal except for mild soft tissue swelling in the right thigh. The lesion was confirmed as an acute osteomyelitis with subperiosteal abscess on surgery. Staphylococcus aureus was the etiologic organism. We describe a case of acute osteomyelitis in a one-year-old boy shown as a cold lesion on bone scan.
Abscess ; Femur ; Humans ; Male ; Osteomyelitis* ; Radioactivity ; Radionuclide Imaging ; Staphylococcus aureus ; Technetium Tc 99m Medronate ; Thigh

PURPOSE: We evaluated the usefulness of quantitative spiral CT to predict postoperative lung function in patients undergoing pulmonary resection. MATERIALS AND METHODS: Fourteen patients in whom pneumonectomy or segmentectomy were performed underwent preoperative chest spiral CT and pulmonary function test(PFT). Six patients underwent postoperative follow-up PFT. Ten patients underwent preoperative radioisotope(RI) lung perfusion scan. Preoperative CT data were postprocessed with contiguous pixel method ranged from -9107HU to -500HU to quantify total functional lung volume(TFLV) and regional volume to be resected(RFLV). Postoperative lung function was predicted by following formula;Predicted postoperative PFT value=preoperative PFT x 1-RFLV/TFLV). CT predicted value was compared with postoperative measured PFT value and those value of RI perfusion scan. RESULTS: CT predicted values were very close to postoperative measured value and RI predicted value, and were correlated well with postoperative measured values (FVC: r=0.988, P<0.001 ;FEV1: r=0.994, P<0.001) and RI predicted values (FVC :r=0.976, P<0.001 ;FEVl: r=0.974, p<0.001). CONCLUSION: Quantitative spiral CT was useful to predict postoperative lung function and could be an effective alternative to RI perfusion scan.
Follow-Up Studies ; Humans ; Lung* ; Mastectomy, Segmental ; Perfusion ; Pneumonectomy ; Thorax ; Tomography, Spiral Computed*

PURPOSE: There have been repoty on radiological features of lower respiratory track infection in infants and children caused by RSV(respiratory syncytial virus) in KOREA. The aims of this study were to summarize radiological features of lower respiratory tract infection caused by common viral agents other than RSV and to find any specific radiological features which might provide clue to the etiologic diagnosis. MATERIALS AND METHODS: We retrospectively analyzed radiological features in 51 children with symptoms of lower respiratory tract infection and identification of viral agents(except RSV). They included parainfluenza (n=22), adenovirus(n=16), influenza A(n--11), influenza B(n=2) virus infections. The mean age of the patients was 23 months. RESULTS: Major radiological findings of viral lower respiratory tract infection were bilateral parahilar peribronchial infiltration(62%), bilateral overaeration(60%), atelectasis(59%)(segmental or subsegmental atelectasis(43%), Iobar atelectasis(16%)) and patchy or confluent consolidation(20%). Pleural effusion was seen in only one case and hilar adenopathy was not observed in any of them. In the cares of adeno virus, consolidation was seen in 5 cases(31%) including 3 cases919%) of extensive confluent consolidations and overaerations were less frequent findings(44%) than in other viruses. In 24 patients with radiological follow up for more than 1 week, consolidation improved most rapidly, while was persistent atelectasis. CONCLUSION: The major radiologic features in vital lower respiratory tract infection(except RSV) were overinflation, bilateral peribronchial infiltration and atelectasis. In adenoviral infection, confluent consolidations which are usually seen in bacterial pneumonia were more common findings than in other viral lower respiratory tract infections.
Child ; Diagnosis ; Follow-Up Studies ; Humans ; Infant* ; Influenza, Human ; Korea ; Paramyxoviridae Infections ; Pleural Effusion ; Pneumonia, Bacterial ; Pulmonary Atelectasis ; Respiratory System* ; Respiratory Tract Infections ; Retrospective Studies

PURPOSE: Because of complex inguinal structures, we cannot overcome the neurogenic complications in open inguinal herniorrhaphy. Nowadays, there are few studies of anatomical danger zones in open herniorrhaphy. So, in this study we would cover the danger zones in hernia surgery with a cadaver. METHODS: We studied the anatomic structures of three male cadavers. There was no anatomical variation among them. We can ascertain the running of the ilioinguinal nerve, iliohypogastric nerve, and genitofemoral nerve. RESULTS: We can see that the ilioinguinal nerve runs anterior to the spermatic cord in the inguinal canal and lies beneath the external oblique aponeurosis. The iliohypogastirc nerve runs on the anterior surface of the internal oblique muscle, and aponeurosis medial and superior to the internal ring. The genital branch of the genitofemoral nerve lies on the iliopubic tract and accompanies the cremaster vessels to form a neurovascular bundle. In these areas, we often suture the anchor in open herniorrhaphy, increasing probability of these nerves suffering injury. CONCLUSION: In open inguinal herniorrhaphy, surgeons must have a comprehensive understanding of the neural anatomy of the groin to reduce post-operative complications. Moreover, we must consider not only anatomical understanding but also surgical procedures reducing neurogenic complications. So, we suggest certain procedures to reduce nerve injury such as three dimensional mesh or the use of fibrin glue.
Cadaver ; Fibrin Tissue Adhesive ; Groin ; Hernia ; Herniorrhaphy ; Humans ; Inguinal Canal ; Male ; Muscles ; Running ; Spermatic Cord ; Stress, Psychological ; Sutures

BACKGROUND: Severe or massive postpartum hemorrhage (PPH) has remained a leading cause of maternal mortality for decades across the world and it results in critical obstetric complications. Recombinant activated factor VII (rFVIIa) has emerged as a gold standard adjunctive hemostatic agent for the treatment of life-threatening PPH refractory to conventional therapies although it remains off-licensed for use in PPH. We studied the effects of rFVIIa on coagulopathy, transfusion volume, prognosis, severity change in Korean PPH patients. METHODS: A retrospective review of medical records between December 2008 and March 2011 indicating use of rFVIIa in severe PPH was performed. We compared age, rFVIIa treatment, transfusion volume, and Sequential Organ Failure Assessment (SOFA) score at the time of arrival in the emergency department and after 24 hours for patients whose SOFA score was 8 points or higher. RESULTS: Fifteen women with SOFA score of 8 and above participated in this study and eight received rFVIIa administration whereas seven did not. Patients' mean age was 31.7 ± 7.5 years. There was no statistically significant difference in initial and post-24 hours SOFA scores between patients administered rFVIIa or not. The change in SOFA score between initial presentation and after 24 hours was significantly reduced after rFVIIa administration (P = 0.016). CONCLUSIONS: This analysis aimed to support that the administration of rFVIIa can reduce the severity of life-threatening PPH in patients. A rapid decision regarding the administration of rFVIIa is needed for a more favorable outcome in severe PPH patients for whom there is no effective standard treatment.
Emergency Service, Hospital ; Factor VIIa* ; Female ; Humans ; Maternal Death ; Maternal Mortality ; Medical Records ; Organ Dysfunction Scores ; Postpartum Hemorrhage* ; Postpartum Period* ; Prognosis ; Recombinant Proteins ; Retrospective Studies

Recently autogenous nerve graft was usually used for segmental defect of peripheal nerve injury. In case of inappropriate size or amount of donor nerve graft, there were many studies included nerve regeneration with special nerve conduit material. To compare the result of autogenous nerve graft with that of silicone tubing method in segmental defect of sciatic nerve, the experiments were carried out on adult rats with autogenous nerve graft on the left side and silicone tubing on the right side. The results were as follows; 1. Myelinated nerve fibers were larger in silicone tubing method than autogenous nerve graft at postop. 4 weeks. 2. There was no difference in nerve regeneration in both groups at postop. 12 weeks. 3. Some atrophic changes were showed in denervated muscles in both groups at postop. 4 weeks. Skeletal muscle changes between the two groups were meagre. 4. Perineural adhension was rare in silicone tubing group in contrast to autogenous nerve graft group. 5. Nerve Conduction Velocity was similar between autogenous nerve graft and silicone tubing method after 4 weeks postoperatively. In conclusion, this study suggests that silicone tubing can be useful method to repair the large nerve gaps and has a potential clinical utilization in large segmental nerve defect.
Adult ; Animals ; Autografts ; Humans ; Methods ; Muscle, Skeletal ; Muscles ; Nerve Fibers, Myelinated ; Nerve Regeneration ; Neural Conduction ; Rats ; Sciatic Nerve ; Silicon ; Silicones ; Tissue Donors ; Transplants

PURPOSE: This study aimed to determine the appropriate stimulus strength that could result in a positive effect on the ankle joint spasticity when patients with chronic stroke performed whole body vibration (WBV) exercise. METHODS: Among 72 patients who were diagnosed with stroke at least 6 months ago, those able to perform a half squat pose with ambulation issues due to ankle joint spasticity (modified Ashworth scale, MAS≥2) were included for analysis. Individuals participated in four different frequencies of vertical WBV exercise; 0 Hz, 10 Hz, 20 Hz, and 30 Hz. Vibration amplitude was 3-4 mm and 5 minutes WBV exercise was performed at each frequency, followed by a measurement after 2-minute rest. We assigned 18 individuals to each frequency and asked them to participate in the WBV exercise once every 3 weeks. The level of spasticity was evaluated by visual analogue scale (VAS) for self-assessment. The myoton PRO was utilized to objectively evaluate the level of spasticity and check the muscle tone and stiffness. RESULTS: Participants showed 0 Hz VAS was a significant difference between 20 Hz application conditions (p < 0.05). Muscle tone was significantly different at 0 Hz between 20 Hz, and 30 Hz (p < 0.05), significantly difference at 10 Hz between 30 Hz (p < 0.05). Muscle stiffness significantly difference at 0 Hz between 20 Hz, and 30 Hz (p < 0.05), significantly difference at 10 Hz between 20 Hz, and 30 Hz (p < 0.05). CONCLUSION: Findings of this study show that the frequency of more than 20 Hz was effective in improving the ambulatory ability in patients with chronic stroke. Currently, the effective WBV protocol is limited. Hence, this study was designed to suggest an effective WBV protocol to improve neuromodulation ability for chronic stroke patients.
Ankle Joint* ; Ankle* ; Humans ; Muscle Spasticity* ; Self-Assessment ; Stroke* ; Vibration* ; Walking

PURPOSE: We evaluated the MR and CT findings of the masticator space lesions in order to identify the differences among the malignant and benign tumors and infectious conditions. MATERIALS AND METHODS: MR and CT findings in 46 cases with proven masticator space lesions were reviewed retrospectively. We analysed the involvement of masticator muscles, adjacent spaces, orbit and intracrahium, homogeneity, necrosis, cystic changes, growth patterns, calcifications, enhancement patterns, MR signal intensity, and CT attenuation. RESULTS: Among the 29 cases of malignant tumors, seven cases were mandibular tumors including four chondrosarcomas, and 22 cases were extramandibular tumors. Malignant tumors of mandibular origin showed large masses with severe bone destruction and epicenter of mandible. Extramandiblular malignant tumors showed the epicenter out of the mandible and less severe bone destruction than mandibular tumors: Among the nine benign tumors, four cases were ameloblastomas which showed the well-defined masses and the expansion of the mandible, and four cases were extramandibular tumors which showed well-marginated extramandibular masses with no bone destruction. Among the eight infectious conditions, five cases were mandibular osteomyelitis with or without abscess formations, and the other three cases were infections from adjacent soft tissue or limited to the soft tissue. CONCLUSION: By careful observations of growth patterns, involvement of the masticator and adjacent spaces, bone changes, and epicenter of the lesions, one can discriminate a mandibular lesion from an extramandibular lesion. With this approach, it is thought to be easier to suggest a dignosis among a wide spectrum of masticator lesions.
Abscess ; Ameloblastoma ; Chondrosarcoma ; Magnetic Resonance Imaging* ; Mandible ; Muscles ; Necrosis ; Orbit ; Osteomyelitis ; Retrospective Studies

PURPOSE: To describe MR findings of recurred giant cell tumor of bone. MATERIALS AND METHODS: MR imagings of ten cases of pathologically proven recurrence of giant cell tumor were retrospectively analyzed. Location of recurrence, multiplicity of recurred tumor, signal intensity and homogeneity, pattern of gadolinium enhancement, soft tissue and articular surface involvement were evaluated. RESULTS: Tumors were located in peripheral portion of previous operation site(80%). Six cases recurred as multiple lesions. Tumor showed low signal intensity on T1 weighted images(100%), high signal intensity on T2 weighted images(100%) and inhomogeneous peripheral rim enhancing pattern(75%). Soft tissue and articular surface involvement were also demonstrated. CONCLUSION: We concluded that characteristic MR findings of recurred giant cell tumor could be helpful in early detection and precise evaluation of tumor recurrence.
Gadolinium ; Giant Cell Tumor of Bone ; Giant Cell Tumors* ; Giant Cells* ; Recurrence ; Retrospective Studies