Arytenoid subluxation or recurrent laryngeal nerve paralysis may result from injury to the larynx following endotracheal intubation or blunt laryngeal trauma. Early diagnosis is important for appropriate treatment and better prognosis. A 62-years-old man was admitted for cholecystectomy. He was intubated without any difficulty and nasogastric tube was inserted with the help of laryngoscope and Magill forcep before surgery. He had a weak voice and hoarseness after atraumatic extubation and those symptoms did not improve even 2 days after. Indirect laryngoscopy, videolaryngotelescopy, electromyography(EMG) and computed tomographic findings revealed anterior, inferior subluxation of left cricoarytenoid cartilage associated with left thyroarytenoid muscle denervation and resultant unilateral vocal cord palsy. Conservative treatment for 40 days after the operation and follow-up examination was done. The voice quality was improved and indirect laryngoscopy examination showed that right vocal cord crossed midline in a attempt to meet its paralyzed counterpart on phonation.
Anesthesia, General* ; Cartilage ; Cholecystectomy ; Denervation ; Early Diagnosis ; Follow-Up Studies ; Hoarseness ; Intubation, Intratracheal ; Laryngeal Muscles ; Laryngoscopes ; Laryngoscopy ; Larynx ; Paralysis* ; Phonation ; Prognosis ; Recurrent Laryngeal Nerve* ; Surgical Instruments ; Vocal Cord Paralysis ; Vocal Cords ; Voice ; Voice Quality

No abstract available.
Leptospira interrogans* ; Leptospira*

No abstract available.
Cushing Syndrome*

Bacteroides fragilis is a Gram negative nonsporulating anaerobic rod bacterium that makes up about 1 to 2% of the norrnal human colonic microflora. In 1984, Myer et al. reported that some strains of B. fragilis produce enterotoxin and cause diarrheal disease in cattle and human. Since then it has been termed enterotoxigenic B. fragilis (ETBF). In this study, we tried to detect enterotoxin gene from 37 B. fragilis strains, isolated in Korean patients, to confirm the existence of ETBF and usefulness of PCR as a rapid diagnosis method. By this method, we identified 9 ETBF strains and confirmed their pathogenesis by cytotoxicity test. No significant cross- reactivity with other anaerobes or aerobes was observed. Thus, the PCR method may be considered useful for the sensitive and rapid detection of anaerobic infections. And the entire amplified PCR mixture was ligated into a pT7Blue T-vector and transformed into E. coli. When the nucleotide sequences of cloned PCR products were compared with reported enterotoxin gene, pBF529 inserted DNA sequence was nearly in good agreement with it but pBF570 inserted DNA sequence showed some difference at nucleotide 270-300. A search for nucleotide sequence homologies revealed that pBF529 exhibited 99%, but pBF570 indicated only 90% identity with reported enterotoxin gene. According to these results, it was suggested that ETBF toxin can be differentiated into at least 2 subtypes.
Animals ; Bacteroides fragilis* ; Bacteroides* ; Base Sequence ; Cattle ; Clone Cells ; Colon ; Diagnosis ; Enterotoxins* ; Humans ; Korea* ; Polymerase Chain Reaction*

BACKGROUND: In order to evaluate the prevalence of enterovirus and cytomegalovirus infections to terminally failing hearts, the presence of enteroviral RNA and cytomegaloviral DNA was screened in the explanted hearts of transplantation recipients. METHODS: RNA and DNA extractions were performed from explanted failing hearts (N=22) and normal hearts (N=5). Reverse transcription-polymerase chain reaction (RT-PCR) of enterovirus and polymerase chain reaction (PCR) of cytomegalovirus were performed. In situ RT-PCR and in situ PCR were performed with positive nucleic acids of viruses. RESULTS: The positivity of enterovirus in failing hearts was 4.4% (1/22) and 0% (0/5) in normal hearts in nested RT-PCR. There was no significant difference in positivity of enteroviral RNA between failing and normal hearts. Nuclei of myocardium was stained in dark-violet color with in situ RT-PCR. The positivity of cytomegalovirus in failing hearts was 45% (10/22) and 40% (2/5) in nested PCR. There was no significant difference in positivity of cytomegaloviral DNA between failing and normal hearts. Nuclei of myocardium was stained in dark-violet color with in situ PCR. Positive chambers of cytomegalovirus were in decreasing tendency according to increasing patient's age. CONCLUSION: Enterovirus was very rarely observed in explanted terminally failing hearts and cytomegalovirus was frequently found both in explanted failing hearts and normal. These viruses have little direct causal relationship with the development of heart failure.
Cardiomyopathy, Dilated ; Cytomegalovirus Infections* ; Cytomegalovirus* ; DNA ; Enterovirus* ; Heart Failure ; Heart* ; Humans* ; Mass Screening* ; Myocardium ; Nucleic Acids ; Polymerase Chain Reaction ; Prevalence ; RNA

From January 1979 to December 1983, eighty-five patients who had forearm bone fracture were treated by four different methods at the Department of Orthopedic Surgery, Chosun University Hospital. The results were as follows: 1. Among 85 patients, 12 patients were radius fractures, 19 patients were ulna fractures, 54 patients were both forearm bone fractures. 2. Closed fractures were 70 patients and the open fractures were 15 patients. 3. The mst common fracture site was middle third of the both radius and ulna. 4. The treatments were closed reduction with cast immobilization, intramedullary nailing or plate and screw fixation. 5. The time required for radiological bone union were shorter in compression plate fixation gmup, than those treated with other fixation device. 6. Functional result was claasified according to the rating system of Smith and Sage. The open reduction and internal fixation group had better results than the conservatively treated group.
Forearm ; Fracture Fixation, Intramedullary ; Fractures, Bone ; Fractures, Closed ; Fractures, Open ; Humans ; Immobilization ; Orthopedics ; Radius ; Radius Fractures ; Ulna ; Ulna Fractures

No abstract available.
Extremities* ; Osteogenesis* ; Ultrasonography*

BACKGROUND: Clostridium difficile is known as the major cause of nosocomially acquired diarrhea. Various phenotypic and genotypic methods have been used to subtype C. difficile strains. The purpose of the present study is to evaluate several typing methods which can be used as tools for subtyping C. difficile isolates for epidemiological studies. METHODS: In two Korean tertiary care hospitals, a total of 81 C. difficile isolates were collected from symptomatic, hospitalized patients in 1998. All isolates were examined for the release of toxin A and toxin B by PCR assay and cell culture assay. Also arbitrarily primed-PCR and PCR-ribotyping profiles were determined for the typing of C. difficile strains on a genetic level. RESULTS: The toxin B gene was detected in 65.4% (54/81) of isolates by both PCR assay and cell cultureassay. Nine types were identified with T-7 primer, and 13 types were identified with PG-05 primer in AP- PCR. Sixteen types were identified in PCR-ribotyping. When two typing methods were compared, reproducibility by PCR-ribotyping was 100%, while it was only 83% and 33% AP-PCR with primer T-7, and PG-05, respectively. The discrimination index was 0.88 for PCR-ribotyping, 0.82 for AP-PCR with primer T-7 and 0.81 with primer PG-05. CONCLUSION: These data suggest that PCR-ribotyping provides a reproducible, discriminatory, and simple alternative to conventional molecular approaches for typing strains of C. difficile.
Cell Culture Techniques ; Clostridium difficile* ; Clostridium* ; Diarrhea ; Discrimination (Psychology) ; Epidemiologic Studies ; Humans ; Polymerase Chain Reaction ; Tertiary Healthcare

A clinical study on the 41 cases of Henock-Schoenlein purpura in infancy and childhood was made. The results are as followings. 1) The cases were seen mostly in the age group of 4 to 10 yr (63.5%), with the peak incidence in 6~10 yr age group(44%). 2) Males were more affected than females with the Male to Female ratio of 2:1. 3) The peak seasonal incidence was seen in spring with 15 cases (37%) and Winter was in the second place with 12 cases (29%). 4) The previous history of the upper respiratory tract infection was present in 17 cases (41%). 5) The main clinical manifestations were skin rash (100.0%), abdominal pain (73%), nephritis (46%) and joint pain (39%) in order. 6) The most common type of skin rash in Henock-Schoenlein purpura and urticarial wheal with erythematous rash (73%) on the lower extremities. 7) In gastointestinal manifestation of Henock-Schoenlein purpura, abdominal pain was noted in all cases (100%) and next is was vomitting (37%). 8) Joints most often involved were the knee (94%) and ankle (44%) joints and the wrists (31%) and elbow (13%) joints subsequently. 9) The renal manifestation of Henock-Schoenlein purpura was the most serious sign. Proteinuria and micro and gross hematuria were seen in all cases (100%) with renal mvoluement. 10) The Anti-streptolysin O titer was increased in 8 cases (28.5%).
Abdominal Pain ; Ankle ; Arthralgia ; Elbow ; Exanthema ; Female ; Hematuria ; Humans ; Incidence ; Joints ; Knee ; Lower Extremity ; Male ; Nephritis ; Proteinuria ; Purpura ; Purpura, Schoenlein-Henoch* ; Respiratory Tract Infections ; Seasons ; Wrist

No abstract available.
Fibroma* ; Testis