The metacercariae of Metagonimus yokogawai were isolated from the sweetfish Plecoglossus altivelis, clollected at Hwagae, South Kyongsang Do, one of the newly known endemic foci of metagonimiasis in Korea. The body structure of metacercaria of M.yokogawai was described and the measurements of the excysted metacercaria were also made. In order to know the distribution of metacercariae within the host, the rate of infection and the intensity of infection, a total of 10 sweet fishes was examined and it was found all infected, from which a total of 38,511 metacercariae was isolated. The number of metacercariae in a fish varied from 219 to 14,427. The average number of metacercaria per fish was 3,851. The distribution of metacercariae in the four divided parts of fish was observed in the following order; number of metacercaria in the muscles; 2,417 (62.8%), in the subcutaneous tissues; 1,126.9 (29.3%), and on the scale; 291.9(7.7%). The development of the metacercaria of M. yokogawai in the mouse host was experimentally traced every day for 10 days after infection . In an earlier period of infection, the growth rate of the genital primordia was distinctly high, particularly in the testes. The seminal receptable and seminal vesicle became clearly recognized in measurable size at 4 days after infection. The vitelline follicles and their ducts were also first visible in the living specimens at 6 days after infection. The oral sucker was larger in size than the ventral sucker in an early stage of the worms, however after 7 days after infection it reversed. The posterior part of body began to extend since two days after infection. Fully matured worms were able to collect only after 7 days after infection. At this stage, the body of worm became 0.7 mm long and 0.3 mm wide. The first positive appearance of eggs in the uterine tubule and in feces was on the 6th day and 10th day of infection, respectively. In an earlier stage of infection, the worms were found mostly in the upper portion of small intestine and the recovery rates of the worms were high, however according to the course of infection in later stage they were seen rather in the lower part of the intestine and the recovery rate also decreased.
parasitology-helminth-trematoda ; Metagonimus yokogawai ; development ; metacercaria ; Plecoglossus altivelis

Marjolin is ulcer may be defined briefly as a cancer arising in a bum scar. A 41-year-old female had a Marjolin is ulcer(12x10x3cm) on her right lower leg. This ulcerated tumor has been present for two and half months and the induction period sinnc her bum was 29 years. The pathologic diagn.osis was squamous cell carcinoma, grade 2. Roentgenograms of her right lower leg revealed several soft tissue masses densities which, in part, horizontally connected with the periosteum of the tibia. So she was treated by above-knee amputation with dissection of several, unenlarged inguinal nodes which showed no evidence of metastases. She developed large, single, fixed metastatic node in right inguinal area one month after amputation and dissection was done.
Adult ; Amputation ; Carcinoma, Squamous Cell ; Cicatrix ; Female ; Humans ; Leg ; Neoplasm Metastasis ; Periosteum ; Tibia ; Ulcer*

Decreased sensitivity of N. gonorrhoeae to many existing antibiotics and the emergence and increase of penicillinase producing and of spectinomycin resistant N. gonorrhoeae necessitate intensive efforts to study on resistance. Male patients with uncomplicated gonococcal urethritis treated during the year 1990 at the VD clinic of Choong-ku Public Health Center in Seoul were included in this study. A total of 85 strains, 44 strains of non-PPNG and 41 strains of PPNG isolated from the patients were studied to evaluate their sensitivities to ampicillin, penicillin, cefoxitin, kanamycin, tetracycline, erythromycin, spectinomycin and cotrimazole. The results are summerized as follw: In non-PPNG strains, the range of MICs. MIC50 and MIC90 for both ampicillin and penicillin were 0.125-32, 2 and 16 mcg/ml respectively. For cefoxitin, they were 0.125-8, s and 16 mcg/ml respectively, and for kanamycin, 8--<64, 32 and 64 mcg/ml, respectively. For tetracycline, they were 1-64, 8 and 32 mcg/ml, while for erythromycin, 0.06-16, 2 and 8 mcg/ml respectively. For spectinomycin, they were 4--<64, 32 and 64 mcg/ml and for cotrimazole, 5--<160, 40 and 160 mcg/ml respectively. In the case of PPNG, the range of MICS, MIC50 and MIC90 for ampicillin were 8--<128, 32 and 128 mcg/ml respectively but for penicillin, 8--<128, 64 and 128 mcg/ml respectively. And for cefoxitin, they were 0.5-32, 4 and 16 mcg/ml while for kanamycin, 16--<64, 64 and >64 mcg/ml respectively. For tetracycline, the values were 2-64, 16 and 32 mcg/ml, and for erythromycin, they were 0.5-16, 4 and 8 mcg/ml respectively. for spectinomycin, they were 8--<64, 32, and 64 mcg/ml and finally for cotrimazole, 5--<160, 80 and 160 mcg/ml respectively. From these results, it is concluded that the MICs of both PPNG and non-PPNG were about 2 folds higher than the results of sensitivity tests at the same instituition in 1985. 2) The prevalence of PPNG among 35 gonorrhoeae patients who received treatment before the visit was 60% (21/35), while that among the patients without previous treatment was 40% (20/50). 3) In the cases of ampicillin, penicillin and cotrimazole, their MIC values were found to be significantly higher for the strains isolated from the patients with previous treatment history than those without previous treatment (p<0.05). 4) In non-PPNG strains, a significant positive correlation is found between the sensitivities to most pairs of ampicillin, penicillin, cefoxitin, kanamycin, tetracycline, erythromycin and spectinomycin. However this excludes some pairs such as : tetracycline-cefoxitin, erythromycin-penicillin, erythromycin-cefoxitin, spectinomycin-penicillin, and spectinomycincefoxitin (p<0.05). 5) In PPNG strains, a significant positive correlation is also found between the sensitivities to most pairs of ampicillin, penicillin, cefoxitin, tetracycline, erythromycin and spectinomycin. However, the exceptional cases include tetracycline-cefoxitin, erythromyoinpenicillin, erythromycin-cefoxitin, spectinomycin-penicillin, and spectinomycin-cefoxitin pairs. In addition, the sensitivity to kanamycin was found to be strongly correlated with that to tetracycline, erytheromycin and spectinomycin (p<0.05). Therefore it is essential for the management fo gonorrhoeae, together with a correct diagnosis, to use currently most effective treatment regimens which would also prevent the emergence of resistant strains. It is also suggested that when a treatment is failed, to use the durg which do not show correlation in sensitivities on re-treatment.
Ampicillin ; Anti-Bacterial Agents ; Antibodies* ; Cefoxitin ; Diagnosis ; Erythromycin ; Humans ; Kanamycin ; Male ; Penicillinase ; Penicillins ; Prevalence ; Public Health ; Seoul ; Spectinomycin ; Tetracycline ; Urethritis

The chronic osteomyeltis of the adult long bones has different problems from the acute osteomyelitis and osteomyelitis of the children. The ischemic scar tissues and infected bones of the chronic csteomyelitis in the adult are resistant to the antibiotic therapy and their healing mechanisms are delayed. The chronic osteomyelitis has no single effective method of treatment since every case reveals different conditions and the treatment should be individualized case by case. 87 cases of chronic osteomyelitis of the adult long bones were studied in the department of orthcpaedic surgery, Fatima Hospital for 7 years during the years between 1973 to 1979. The cases were 65 male and 22 female having ages 35 years in average and the duration of the osteomyelitis was 14 years and 4 months in average ranging from 3 months to 50 years. The cau ative organisms were mostly staphylococcus but Gram (−) bacilli were found in 28% and the adjacent joint problems were found in 38% The cases were analysed in 5 different groups according to x-ray findings as follows; I. Group with sequestrum: 23 cases having sequestra with varying degree of bone sclerosis and destruction. Most cases had draining sinus but the soft tissue involvement was not severe. II. Sclerotic group: 32 cases having significant bone sclerosis with minimal destructicn if any. The soft tissue involvement and scarring were severe but involvement of the bone marrow was not significant. The duration of osteomyelitis was longest having recurrent episodes of the painful swelling in most cases. III. Destructive group: 17 cases with significant bone destruction with varying degree cf sclerosis. The involvement of the bone marrow was significant and soft tissue involvement was not marked The duration of osteomyelitis was short mostly. IV. Group with skin problem: 9 cases having scar problems overlying tibia. V. Group with complication: There were 2 pathologic fractures of the femurs, 3 quamous cell carcinomas on the lower legs and a severe deformity of a leg. Treatment was mostly surgical including 4 amputations. The surgical method was focused on saucerization of the bone and extensive excision of the infected soft tissues and the scar tissues. 23 cases having small or no dead cavity after mobilization and suture of the adjacent healthy soft tissue closed primarily. Otherwise the cavity was packed open for econdary healing in other 23 cases including several cases having big cavity which was unable to close the skin. The cases having big cavity were prepared for continueus irrigation in 14 caes which were able to closed skin. The transposition of muscles to fill the dead cavity was performed in 4 cases that had big cavity and was unable to close skin. The results were healing in 10 weeks in 54% and after 10 weeks in 38% and 8% failed to heal with the first trials. The recurrence of the ostecmyelitis was found in 9 cases among the 42 cases followed for I year and 3 months in average mostly in group II and in cases of primary closure and open packing.
Adult ; Amputation ; Bone Marrow ; Child ; Cicatrix ; Clinical Study ; Congenital Abnormalities ; Female ; Femur ; Fractures, Spontaneous ; Humans ; Joints ; Leg ; Male ; Methods ; Muscles ; Osteomyelitis ; Recurrence ; Sclerosis ; Skin ; Staphylococcus ; Sutures ; Tibia

Four families having identical sacral agenesis were reported in the literatures and an another family is added here. This family has an eleven year old boy and a seven year old girl who have identical complete sacral agenesis without spincter disturbance but with some anomalies in the other spines, rib and progressive club feet. These cases are followed for six years and the foot deformity was corrected by surgery.
Female ; Foot ; Foot Deformities ; Humans ; Male ; Ribs ; Sacrum ; Spine

During the past three years, 110 consecutive cases of intravenous lidocaine anesthesia under tourniquet for surgery in the upper extremities were observed. The cases were simple injuries or diseases which needed simple surgery or closed reduction requiring only a short period of time. A tourniquet with double cuff was utilized. After tourniquet inflation, 0.5% or 0.75% lidocaine was injected intravenously in the amount of 1.5 mg per Kg body weight. Satisfactory anesthesia was performed in all except 18 cases who had some discomfort of tourniquet origin and analgesics were necessary. No significant complication was noticed. The technic was very simple, safe and effective for simple procedures on hands or forearms.
Analgesics ; Anesthesia ; Anesthesia, Conduction ; Body Weight ; Forearm ; Hand ; Inflation, Economic ; Lidocaine ; Tourniquets ; Upper Extremity

We describe the clinical and pathologic observation of a 50-year-old man with superficial disseminated porokeratosis who developed a squamous cell carcinoma on the dorsum of his right thumb and Bowens disease on his right upper arm. The tumors were surrounded by lesions of superficial disseminated porokeratosis and were thought to develop from the dysplastic epidermal cells located under the comoid lamellae.
Arm ; Bowen's Disease* ; Carcinoma, Squamous Cell* ; Epithelial Cells* ; Humans ; Middle Aged ; Porokeratosis* ; Thumb

Twelve cases of compression arthrodesis of the knee, which was performed during the period 1973 to 1978, were reviewed. All of the cases had tuberculous arthritis of the knee and included 3 children. Post-operative management was carried out with compression in a long leg cast with crutch walking for an average of 6 weeks and successive cylinder casts without compression and permitting full weight bearing were applied on an average of every 7 weeks. All cases eventually revealed bony fusion and the tuberculosis subsided without signiflcant complications even in the children.
Arthritis ; Arthrodesis ; Child ; Humans ; Knee ; Leg ; Tuberculosis ; Walking ; Weight-Bearing

There is debatable opinions as to the nature and clinical significance of the changes that may occur in the spine after posterior spine fusion performed in growing children. Clinical survey is known to be difficult because X-ray films in children are not easy to interpret and measure in the presence of disease and accuracy is uncertain due to magnification on X-ray films. Authors selected 8 cases of tuberculous spondylitis which were managed with posterior spine fusion under the criterias that cases had surgery under 10 years old, no evidence of pseudoarthrosis clinically and roentgenologically on serial examinations at least once 1 year, follow-up more than 2 years since 3 months after surgery, enough spines are included on lateral X-ray films, and accurate measurement and correction of magnification are possible. The cases were surveyed for changes occured in fused spines after posterior spine fusion and the results were as follows: 1. There was actual lengthening of grafted bone mass after solid fusion in all cases although the amounts were minimal. 2. The fused spines grew 46% on an average less than adjacent normal unfused spines. 3. The vertebral bodies of fused spines grew nearly same as the adjacent normal vertebral bodies. 4, The intervertebral disc spaces of the fused spines were narrowed in all cases. 5. The intervertebral angles had tendency to increase and kyphosis angles to decrease.
Child ; Follow-Up Studies ; Humans ; Intervertebral Disc ; Kyphosis ; Pseudarthrosis ; Spine ; Spondylitis ; Transplants ; X-Ray Film

Nemaline myopathy is a rare congenital m opathy, characterized by nonprogressive or slowely progressive muscle weakness associated with rod-like structures in muscle fibers and characteristic dysmorphic features. We report the first farnilial nemaline myopathy in two generations of the same family, confirmed by muscle biospy in an 11-year-old boy and his mother. The patients had hypotonia and slowly progressive muscle weakness of the four limbs associated with characteristic facial dysmorphism and skeletal deformities. Light and electron microscopic study of a muscle biopsy showed numerous nemaline rods in both patients.
Biopsy ; Child ; Congenital Abnormalities ; Extremities ; Family Characteristics ; Humans ; Male ; Mothers ; Muscle Hypotonia ; Muscle Weakness ; Myopathies, Nemaline*