The value of the bone scan in pyogenic bone and joint infections is demonstrated in patients who had signs and symptoms suggestive of bone or joint infection. Nineteen patients were evaluated with 99m Tc-methylene diphosphonate bone scan and roentgenogram. The diagnosis of acute osteomyelitis was made in eight patients, chronic osteomyelitis in six patients, septic arthritis in three patients and two patients had soft tissue infection only. Seven of the eight patients with acute osteomyelitis had focal increase of radiopharmaceutical uptake in the bone well before the bony change appeared on roentgenogram. Five of six chronic osteomyelitis patients had not only bony change on roentgenogram but also increased radiopharmaceutical uptake of bone. But the remaining one had only the former, and the lesion was interpreted as inactive. In two of three septic arthritis patients, the lesion was in S-I joint and both of them had no abnormality on roentgenogram but had increased uptake of radiopharmaceutical agent in the joint. Two patients with soft tissue infection had no abnormal radiological bony change and no increase of the radiopharmarceutical uptake in bone on bone scan. From the above data, we concluded that bone scan is recommended in the evaluation of the patients with signs and symptoms suggestive of bone or joint infection for the earlier diagnosis and differential diagnosis in acute case and for the determination of the activity and location of the lesion in chronic case.
Arthritis, Infectious ; Diagnosis ; Diagnosis, Differential ; Humans ; Joints ; Osteomyelitis ; Soft Tissue Infections

Spontaneous gastric perforation is an important but rare cause of gastrointestinal perforation in neonates. Just over 200 cases have been reported in the literatures. In spite of recent surgical advances in its managements, mortality rate has been reported as high as 25~50%. Because of physiologic differences, immature immune mechanisms, variations in gastrointestinal flora and poor localization of perforation, a neonate with gastric perforation is at high risk. The pathogenesis is greatly debated. Five patients with spontaneous neonatal gastric perforation who were operated upon at the Department of Pediatric Surgery, Seoul National University Hospital from 1980 to 1993 were reviewed. Four patients were male and one female. The first indication of perforation was 1 day to 6 days of life. All of 5 perforations were located along the greater curvature of the stomach. The size of perforation ranged from 2 cm to 10 cm. Debridement and primary closure were performed in all patients. The operative mortality was 40%(2 of 5). The cause of perforation was not identified in all cases. Prematurity and necrotizing enterocolitis, synchronous or metachrotlous, were thought to be crucial prognostic factors. Earlier recognition and surgical intervention are necessary to reduce morbidity and mortality.
Debridement ; Enterocolitis, Necrotizing ; Female ; Gastrointestinal Microbiome ; Humans ; Infant, Newborn ; Male ; Mortality ; Seoul ; Stomach

BACKGROUND: Mitochondrial trans-2-enoyl-CoA reductase (MECR) is involved in mitochondrial synthesis of fatty acids and is highly expressed in mitochondria. MECR is also known as nuclear receptor binding factor-1, which was originally reported with yeast two-hybrid screening as a binding protein of the nuclear hormone receptor peroxisome proliferator-activated receptor alpha (PPARalpha). However, MECR and PPARalpha are localized at different compartment, mitochondria, and the nucleus, respectively. Therefore, the presence of a cytosolic or nuclear isoform of MECR is necessary for functional interaction between MECR and PPARalpha. METHODS: To identify the expression pattern of MECR and the cytosolic form of MECR (cMECR), we performed reverse transcription polymerase chain reaction (RT-PCR) with various tissue samples from Sprague-Dawley rats. To confirm the interaction between cMECR and PPARalpha, we performed several binding assays such as yeast two-hybrid, coimmunoprecipitation, and bimolecular fluorescence complementation. To observe subcellular localization of these proteins, immunocytochemistry was performed. A luciferase assay was used to measure PPARalpha activity. RESULTS: We provide evidence of an alternatively spliced variant of the rat MECR gene that yields cMECR. The cMECR lacks the N-terminal 76 amino acids of MECR and shows uniform distribution in the cytoplasm and nucleus of HeLa cells. cMECR directly bound PPARalpha in the nucleus and increased PPARalpha-dependent luciferase activity in HeLa cells. CONCLUSION: We found the cytosolic form of MECR (cMECR) was expressed in the cytosolic and/or nuclear region, directly binds with PPARalpha, and enhances PPARalpha activity.
Alternative Splicing ; Amino Acids ; Animals ; Carrier Proteins ; Complement System Proteins ; Cytoplasm ; Cytosol* ; Fatty Acids ; Fluorescence ; HeLa Cells ; Humans ; Immunohistochemistry ; Luciferases ; Mass Screening ; Mitochondria ; Oxidoreductases* ; Polymerase Chain Reaction ; PPAR alpha* ; Rats ; Rats, Sprague-Dawley ; Reverse Transcription ; Yeasts