The CT findings and their differential points were evaluated by reviewing the CT scans of 47 patients with destructive lesions of vertebral bodies which included tuberculous spondylitis(23), pyogenic infection(9), syphilitic spondylitis(1) and malignant lesions(14). Twenty-one(91.3%) of 23 patients with tuberculous spondylitis showed mixed osteolytic and osteosclerotic patterns of bony destruction. Six(66.7%) of 9 patients with pyogenic infection and 10(71.4%) of 14 malignant lesions showed osteolytic pattern of bony destruction. Thirty(90.9%) of 33 infections lesions including pyogenic infection and tuberculous spondylitis involved intervertebral disc, while the involvement of intervertebral disc was not found in malignant lesions. The Swisscheese appearance of bony destruction was commonly seen in tuberculous spondylitis, but pyogenic infections and malignant lesions more commonly revealed geographic or moth-eaten appearance. The sequestral pattern and sclerotic rims in and around bony destruction were mainly seen in tuberculous spondylitis, and they were thought to be specific findings in tuberculous spondylitis. CT of the spine appears to offer the detailed findings of vertebral body destruction and may be a useful adjunct in differentiation between tuberculous spondylitis, pyogenic infections and malignant lesions of the spine.
Diagnosis, Differential* ; Humans ; Inflammation* ; Intervertebral Disc ; Spine ; Spondylitis ; Tomography, X-Ray Computed

BACKGROUND: Chronic suppurative otitis media is one of the most common disease in the otolaryngologic field. It is important to choose of antibiotics in the management of chronic suppurative otitis media. OBJECTIVES: Bacteriologic studies can make it possible to use appropriate antibiotics. MATERIALS AND METHODS: The bacteriologic study was made on 98 cases of chronic suppurative otitis media who visited the department of otolaryngology, Dae Dong Hospital in Pusan from Nov. 1989 to Dec. 1995 and the following results were obtained. RESULTS: 1) In 90 cases in which pathogenic organism was isolated, single infection was 81 cases(90%) and mixed infection was 9 cases(10%). 2) The most frequent pathogenic organism was Staphylococcus(46.5%) and Proteus(16.1%), Pseudomonas(14.1%), Providencia(10.1%) were the next. 3) In the aspect of the sensitivity to antibiotics, Ciprofloxacin, Ceftriaxon and Amikacin were sensitive drug generally. 4) Staphylococcus was sensitive to Vancomycin and Ciprofloxacin. 5) Proteus was sensitive to Amikacin, Ciprofloxacin, and Ceftriaxon. 6) Pseudomonas was sensitive to Ciprofloxacin, Amikacin and Piperacin. 7) Providencia was sensitive to Ciprofloxacin, Ceftriaxon, Amikacin and Piperacin. 8) Methicillin Resistant Staphylococcus Aureus(MRSA) was 19 Strains(45.5%). CONCLUSION: Recently, pathologic strain and it's sensitivity to antibiotics has changed. So, we recommand that periodic bacteriologic study and sensitivity test should be done for effective management of chronic otitis media.
Amikacin ; Anti-Bacterial Agents ; Bacteriology ; Busan ; Ceftriaxone ; Ciprofloxacin ; Coinfection ; Methicillin Resistance ; Otitis Media ; Otitis Media, Suppurative* ; Otolaryngology ; Proteus ; Providencia ; Pseudomonas ; Staphylococcus ; Vancomycin

BACKGROUND: Somatosensory evoked potential (SSEP) has been used to help minimize neurologic morbidity during spinal surgery. But, SSEP is affected by various factors, namely technical errors, anesthetics and physiologic aspects (systemic blood pressure, temperature, blood gas tensions). We experienced 40 cases of spinal surgery done with total intravenous anesthesia under SSEP monitoring. We reviewed these cases with the availability of total intravenous anesthesia during SSEP monitoring. METHODS: Forty patients, ASA class I-II, free of neurologic disease and scheduled for elective spinal surgery were randomly selected for the study. All of the operations were performed under general anesthesia employing the method of total intravenous anesthesia with propofol and fentanyl, and monitored by SSEP. We recorded latency and amplitude of SSEP in the pre-induction, post-induction, during-instrument insertion and post-distraction periods. RESULTS: There were no statistical differences in latencies among pre-induction, post-induction, screw insertion and post-distraction period. The amplitude of the post-induction period was statistically higher than pre-induction period (p<0.05), but there were no differences in other periods. None of cases showed abnormal findings (i.e., delay of latency over 10% or decrease of amplitude over 50%). CONCLUSIONS: SSEP monitoring may be helpful in identifying potentially neurologically threatening surgical maneuvers during spinal surgery. To achieve better outcomes, we should consider the effects of various factors on SSEP. Total intravenous anesthesia may be useful method, which has lifter influence on SSEP monitoring.
Anesthesia, General ; Anesthesia, Intravenous* ; Anesthetics ; Blood Pressure ; Evoked Potentials* ; Evoked Potentials, Somatosensory ; Fentanyl ; Humans ; Propofol

BACKGROUND: Herpes zoster oticus is a reactivation of latent varicella-zoster infection associated with otalgia, vesicle, facial nerve palsy, sensorineural hearing loss & vertigo. Facial paralysis is rapid in onset, usually severe in degree, and poor in prognosis. OBJECTIVES: To evaluate the treatment and prognosis of Herpes zoster oticus. MATERIALS AND METHODS: Retrospective study of 12 cases of Herpes zoster oticus from May 1992 to February 1996, which had been treated with acyclovir and steroid was done. RESULTS: All patients had otalgia, vesicle and facial palsy. All patients had been treated with adequate dosage of prednisolone & acyclovir. The complete recovery rate from facial palsy was 58%. CONCLUSION: Factors predicting good prognosis are as follows. 1) low degree of facial palsy on admission 2) delayed onset of facial palsy from initial symptom 3) early treatment for facial palsy 4) electrical test: Nerve excitability test(<3.5 mA difference) Electroneurography(>10%).
Acyclovir ; Earache ; Facial Nerve ; Facial Paralysis ; Hearing Loss, Sensorineural ; Herpes Zoster Oticus* ; Herpes Zoster* ; Humans ; Paralysis ; Prednisolone ; Prognosis* ; Retrospective Studies ; Vertigo

PURPOSE: The surgical morbidity and mortality after a pancreaticoduodenectomy has been decreasing but still remains high. The most serious complications are pancreatic leakage, gastrointestinal or intra-abdominal hemorrhage, and an intraabdominal abscess. The less serious complications are delayed gastric emptying and wound problems. The aim of this study was to evaluate the risk factors for morbidity and mortality after a pancreaticoduodenectomy. METHODS: Among 90 patients who underwent pancreaticoduodenectomy from Feb. 1992 to Dec, 2000. 68 patients whose hospital records could be reviewed thoroughly were enrolled in this study. The postoperative morbidity and mortality after a pancreaticoduodenal resection were evaluated in terms of the patient's age, combined disease, laboratory values, biliary drainage, transfusion, types of pancreaticojejunostomy, pancreatic duct size, consistency, and the administration of octreotide. Univariate and multivariate analysis were performed with a chi-square test and multiple logistic regression test. RESULTS: Postoperative complications were observed in 43 cases (63.2%). Wound complications were noted in 13 cases (19.1%), gastric emptying disturbance in 10 cases (14.7%), bleeding in 9 cases (13.2%), an abscess in 4 cases (5.9%), and leakage in 22 cases (32.4%). Nine cases (13.2%) had died. The causes of death were sepsis due to leakage in 3 cases, bleeding in 3 cases, and others causes in 3 cases. Univariate analysis showed that diabetes mellitus was significantly (P<0.05) related to delayed gastric emptying. In multivariate analysis, transfusion was significantly (P<0.05) related to wound infections and mortality. Old age ( 65 years) was significantly related to leakage and delayed gastric emptying. CONCLUSION: Pancreaticoduodenectomy is still associated with a high mortality and morbidity rate even though there has been significant progress in the field of pancreatic surgery and postoperative follow-up. Old age and transfusions appeared to be the main risk factors for morbidity and mortality after a pancreaticoduodenectomy in this study. In addition to these factors, better anticipation and management of the postoperative complications is essential for improving the surgical outcome.
Abscess ; Cause of Death ; Diabetes Mellitus ; Drainage ; Follow-Up Studies ; Gastric Emptying ; Hemorrhage ; Hospital Records ; Humans ; Logistic Models ; Mortality* ; Multivariate Analysis ; Octreotide ; Pancreatic Ducts ; Pancreaticoduodenectomy* ; Pancreaticojejunostomy ; Postoperative Complications ; Risk Factors ; Sepsis ; Wound Infection ; Wounds and Injuries

Adventitial cystic disease (ACD) is an uncommon vascular disease of an unknown origin, and this malady can be suspected in a young, healthy patient who has sudden onset of claudication. We describe here a case of ACD of the right popliteal artery. A 43-year-old male presented with 4 month history of severe right leg claudication. He had no other atherosclerotic predisposing history except for 10 pack years of smoking. On examination, the right femoral pulses were normal, the popliteal artery absent and the dorsalis pedis and posterior tibial artey pulses were decreased. The ankle-brachial pressure index (ABI) was 0.4. Ultrasonography showed a hypoechoic cystic lesion with a well-defined marin along the arterial wall. Computed tomography showed a round hypodense cystic mass with thin enhancing rim and a non-enhancing center in the popliteal fossa. Operatively, the 2.5 cm-sized expanding cyst indented the popliteal artery, which involved half of its diameter with adhesion to the adhesion to the adjacent structures. The artery had no thrombosis and it was a short-segment lesion with luminal patency, but half of the arterial wall was thickened with inflammation. Partial excision of the cyst wall and evacuation of the gelatineous materials was performed. Postoperatively, his symptoms improved somewhat, but ABI was 0.6. On the angiography, there was residual stenosis and contrast pooling. These findings disappeared after balloon angioplasty. he was asymptomatic 6 months later with an ABI >1 in the right side.
Adult ; Angiography ; Angioplasty* ; Angioplasty, Balloon ; Arteries ; Constriction, Pathologic* ; Cystotomy* ; Gelatin ; Humans ; Inflammation ; Leg ; Male ; Phenobarbital ; Popliteal Artery ; Smoke ; Smoking ; Thrombosis ; Ultrasonography ; Vascular Diseases

Adventitial cystic disease (ACD) is an uncommon vascular disease of an unknown origin, and this malady can be suspected in a young, healthy patient who has sudden onset of claudication. We describe here a case of ACD of the right popliteal artery. A 43-year-old male presented with 4 month history of severe right leg claudication. He had no other atherosclerotic predisposing history except for 10 pack years of smoking. On examination, the right femoral pulses were normal, the popliteal artery absent and the dorsalis pedis and posterior tibial artey pulses were decreased. The ankle-brachial pressure index (ABI) was 0.4. Ultrasonography showed a hypoechoic cystic lesion with a well-defined marin along the arterial wall. Computed tomography showed a round hypodense cystic mass with thin enhancing rim and a non-enhancing center in the popliteal fossa. Operatively, the 2.5 cm-sized expanding cyst indented the popliteal artery, which involved half of its diameter with adhesion to the adhesion to the adjacent structures. The artery had no thrombosis and it was a short-segment lesion with luminal patency, but half of the arterial wall was thickened with inflammation. Partial excision of the cyst wall and evacuation of the gelatineous materials was performed. Postoperatively, his symptoms improved somewhat, but ABI was 0.6. On the angiography, there was residual stenosis and contrast pooling. These findings disappeared after balloon angioplasty. he was asymptomatic 6 months later with an ABI >1 in the right side.
Adult ; Angiography ; Angioplasty* ; Angioplasty, Balloon ; Arteries ; Constriction, Pathologic* ; Cystotomy* ; Gelatin ; Humans ; Inflammation ; Leg ; Male ; Phenobarbital ; Popliteal Artery ; Smoke ; Smoking ; Thrombosis ; Ultrasonography ; Vascular Diseases

OBJECTIVE: The decision of optimal age for administration of recently approved prophylactic human papillomavirus (HPV) vaccines in the world depend on the basis of the sexual behavior of each countries. The aim of the study was to survey the age-specific sexual behavior including the sexual debut time and sexual experience in the Korean young women to design the tailored HPV vaccination. METHODS: This study was conducted by the Synovate Healthcare in the 6 city of Korea e.g. Seoul, Pusan, Daegu, Incheon, Kwangju and Daejon. By a stratified sampling methods 2,400 women aged 12-29 years old were included. The measures of sexual behavior presented in this report were collected by a Computer-Assisted Self-Interviewing (ACASI), in which the respondent enters her own answers into a computer without telling them to an interviewer. RESULTS: Among women 12-29 years of age, 39 percent of women (934 persons in 2,400 women) and 33 percent of single women (724 persons in 2,190 women) have had vaginal intercourse; 8 percent of women under 19 years old single women (79 persons in 1,045) and 56 percent of single women with 20-29 years old (645 persons in 1,145). Number of sexual partner was 2.8 person and 54 percent of women had more than 2 partners. Age of the first sexual activity (sexual debut) was 21 years old. The age of partner at the sexual debut was 23.2 years old. Sexual experience before 15 years old was only 2%. About the condom, 41% did not use or rarely use. CONCLUSION: Our data demonstrate that the sexual debut time of young Korean women differ from other countries in which the prophylactic HPV vaccine had already used. We conclude that the optimal age for HPV vaccination in Korea would be determined at 15-17 years old by this situation.
Adolescent ; Busan ; Condoms ; Daegu ; Daejeon ; Surveys and Questionnaires ; Delivery of Health Care ; Female ; Gwangju ; Humans ; Incheon ; Korea ; Seoul ; Sexual Behavior* ; Sexual Partners ; Vaccination ; Vaccines ; Young Adult

PURPOSE: To evaluate the incidence and clinical features of age-related macular degeneration (AMD) in Korea. METHODS: Web-based (www.armd-nova.or.kr) registration was conducted for AMD patients aged 50 or more who were newly diagnosed by retinal specialists in Korea from August 20, 2005 to August 20, 2006. Patient data including ophthalmologic examination, fundus photography, fluorescein angiogram and/or indocyanin green angiogram (ICG), past medical history, behavioral habit, combined systemic diseases were up-loaded. RESULTS: Among finally enrolled 1,141 newly diagnosed AMD patients, 690 patients (60.5%) were male and 451 patients (39.5%) were female. The average age of AMD patients was 69.7+/-8.0. Early AMD was observed in 190 patients and 951 patients had late AMD. Classic choroidal neovascular membrane (CNVM) was observed in 18.6% of exudative AMD patients and 63.4 % had occult CNVM. Subfoveal CNVM was observed in 80.4% of the patients with CNVM. Among the 580 exudative AMD eyes that performed indocyanin green angiography (ICG), 184 eyes (31.7%) had polypoidal choroidal vasculopathy (PCV) and 36 eyes (6.2%) showed retinal angiomatous proliferation (RAP). Age, male gender, smoking, diabetes and hypertension significantly increased the risk of the AMD among Koreans. CONCLUSIONS: Because of the low rate of participation by retinal specialists, definite incidence of AMD was not obtainable. However, the estimated 1-year AMD incidence in the Pusan area of Korea is at least 0.4%. In contrast to Western people, 31.7% of exudative AMD cases were revealed to be PCV and 6.2% were revealed to be RAP. This discrepancy between ethnic groups should be considered in the diagnosis and treatment modality selection of Korean AMD patients.
Aged ; Angiography ; Choroid ; Ethnic Groups ; Eye ; Female ; Fluorescein ; Humans ; Hypertension ; Incidence ; Korea ; Macular Degeneration ; Male ; Membranes ; Photography ; Retinaldehyde ; Smoke ; Smoking ; Specialization