Congenital dislocation of the knee is very rare skeletal deformity and was firstly described by Chatelaine in 1822. Since then there have been a few number of case reports and some series discussing the etiology and treatment. The tibia is displaced anteriorly in relation to the femur. It is generally subdassified as simple hyperextention, subluxation, and dislocation depending on the degree of the joint displacement and the severity of disease. Early gentle manipulation and serial splintage or plaster cast are recommended for treatment and were successful in the majority except the case of quadriceps contrarture or late correction. The authors experienced one case of congenital dislocation of the right knee and brief review of the related literatures was made.
Casts, Surgical ; Congenital Abnormalities ; Dislocations* ; Femur ; Joints ; Knee* ; Tibia

BACKGROUND AND OBJECTIVES: Many people experience problems with a dry nasal mucous membrane, often without wondering why. The cause of problem is known as rhinitis sicca, senile rhinitis, and atrophic rhinitis, etc. A common form of treatment for patients who have such symptoms has been to begin by rinsing the inside of the nose with saline solution, to drop peanut oil, to apply antibiotic-ointment and moisturizing agents. Lanolin has been know as a safe skin moisturizing agent and used to treat dry nose. The purpose of this study was to evaluate the effect of lanolin on a group of patients seeking treatment for dryness of the nose. MATERIAL AND METHODS: Ninety-three patients experiencing problems with dry nasal mucosa were selected from the out-patient clinic. Fifty-seven patients, average age 36.3 years old, were treated with 1:2 mixture of lanolin and vaseline ointment. Thirty-six patients, average age 32.0 years, were treated with vaseline ointment. Both ointments were applied three times a day for two weeks. The efficacy of treatment was determined with pre and post-treatment six symptoms on a visual analogue scale: nasal obstruction, crust formation, mucosal dryness, respiratory discomfort, sleep disturbance, and general discomfort. RESULTS: For subjects treated with lanolin, the average VAS value for nasal obstruction was 5.84+/-2.28 and it decreased to 2.89+/-1.29, while the corresponding values for subjects treated with vaseline were 4.39+/-1.77 decreasing to 3.11+/- 1.24 (p<0.05). Crust formation of lanolin treated subjects were 5.67+/-2.39 and it decreased to 2.09+/-1.46, while the vaseline treated subjects were 4.83+/-1.99 decreasing to 2.33+/-1.31 (p<0.05). Average total symptom improvement was 65.7% (from 27.95+/-9.30 to 9.86+/-4.58) in lanolin treated group, while it was 44.8% (from 20.9+/-76.59 to 11.64+/-4.18) in vaseline treated group. CONCLUSION: We found that the efficacy of lanolin was statistically signigicantly better than that of vaseline. During the study period, there was no local reactions have been reported, nor have any allergic reactions. The present study underlines the fact that the way to treat nasal mucosal dryness is to use lanolin ointment.
Humans ; Hypersensitivity ; Lanolin* ; Mucous Membrane ; Nasal Mucosa ; Nasal Obstruction ; Nose* ; Ointments ; Outpatients ; Petrolatum ; Rhinitis ; Rhinitis, Atrophic ; Skin ; Sodium Chloride

BACKGROUND AND OBJECTIVES: Fungi are ubiquitous in the environment and their products may contribute to the development and exacerbation of airway diseases. The respiratory epithelium is the first barrier encountered by airborne allergens and an active participant in airway inflammation. During inflammatory reaction, many inflammatory cells are recruited to tissue from circulation, and they are located in close proximity to the epithelium. In this study, we hypothesized that respiratory epithelial cells and immune cells would interact and fungi could enhance their inflammatory reactions. MATERIALS AND METHOD: BEAS-2B was stimulated with airborne fungi (Alternaria, Aspergillus, Cladosporium, etc) for 24 hours, and then co-cultured with peripheral blood mononuclear cells (PBMCs), CD4+ lymphocytes, natural killer (NK) cells, and monocytes for 3 to 5 days. Interleukin-6 (IL-6), IL-1beta, granulocyte- macrophage colony stimulating factor (GM-CSF), tumor necrosis factor-alpha (TNF-alpha) were measured to determine the activation of immune cells. Transwell insert system was used to determine the importance of physical contact between epithelial cells and immune cells. RESULTS: Fungi, especially Alternaria, enhanced the production of chemical mediators from respiratory epithelial cells. When epithelial cells were co-cultured with immune cells, supernatants contained larger amounts of chemical mediators than when epithelial cells were cultured alone. When co-cultured with activated epithelial cells, TNF-alpha production was significantly increased by PBMCs, and physical contact was needed to interact between epithelial cells and PBMCs. CONCLUSION: This study suggests that fungi enhances the immune reaction between respiratory epithelial cells and peripheral blood immune cells, and the physical contact between epithelial cells and immune cells is needed to enhance the production of cytokines.
Allergens ; Alternaria ; Aspergillus ; Cladosporium ; Colony-Stimulating Factors ; Cytokines ; Epithelial Cells ; Epithelium ; Fungi ; Inflammation ; Interleukin-6 ; Lymphocytes ; Macrophages ; Monocytes ; Respiratory Mucosa ; Tumor Necrosis Factor-alpha

BACKGROUND AND OBJECTIVES: Taste disorders have not received sufficient attention by otolaryngologists and only a few studies have documented the clinical characteristics of taste disorders. We therefore analyzed the characteristics of patients with taste disorders who visited our Taste and Smell Clinic over a 3-year period. SUBJECTS AND METHOD: Sixty patients with taste disorders were investigated. The efficacy of treatment was evaluated according to the age, sex, duration of symptom, cause, and severity of taste disorder. RESULTS: Sixty percent of patients visited the clinic within 6 months of the onset of decrease in taste sensation. Multiple etiology was more common than single etiology. Taste disorder due to olfactory disorder was the most frequent etiology, followed by drug induced taste disorder and taste disorder due to zinc deficiency. Sixty percent of the patients experienced improvement of the taste abnormality. The efficacy of treatment decreased with increasing severity of taste disorder at the initial visit. CONCLUSION: Careful history taking and physical examination are needed for determination of the cause of any taste abnormality. The site and severity of dysgeusia should be determined through the chemical and electrical taste threshold test. Treatment should direct toward the causative abnormality, if possible.
Dysgeusia ; Humans ; Physical Examination ; Sensation ; Smell ; Taste Disorders ; Taste Threshold ; Zinc

Carcinoma of Gall bladder remains a terminal illness in most patients despite improved diagnostic capabilities, better perioperative care and a more aggresive surgical approch based on improved knowledge of this tumors natural histiory. Overall 5-year survival rates remain below 5%. This failure to significantly improve patient oucome is largely due to late recognition of gall badder cancer. Authors experienced 21 cases of gall bladder cancer confirmed by operation at the Kwang Ju Christian hospital from march 1983 to March 1991, and the results obtained were summarized as follows. (continue...)
Gallbladder Neoplasms ; Gwangju ; Humans ; Perioperative Care ; Survival Rate ; Urinary Bladder*

PURPOSE: Investigations of in-hospital pediatric cardiopulmonary resuscitation (CPR) have been of limited value because of the retrospective nature of the studies, the small sample sizes, and inconsistent definitions of cardiac arrest and CPR. The purpose of this study was to prospectively describe in-hospital pediatric CPR by using the Utstein guidelines and to confirm prognosis predictors. METHODS: All 168 in-hospital pediatric CPRs involving 115 patients, at Asan Medical Center from January 1, 2002, to December 31, 2003 were prospectively described and evaluated by using Utstein reporting guidelines. Uniform reports were made out after the CPRs and were supplemented with chart reviews. The outcome variables included sustained return of spontaneous circulation (ROSC), the survival rate at 24 hrs, the survival discharge rate, and the pediatric overall performance category scale (POPC) after CPR. RESULTS: All of the 115 patients who received CPRs, 65 (56.5%) patients had sustained ROSC, 54 (47.0%) patients were alive at 24 hrs, and 33 (28.7%) patients were discharged alive. The most common underlying disease was cardiovascular disease (45.2%), and the most common precipitating cause of CPR was shock (48.7%). The most common initial cardiac rhythm was bradycardia with poor perfusion (41.7%). A multiple logistic regression analysis revealed that death at discharge was independently associated with a higher POPC score before CPR, a longer duration of CPR, and repeated CPR. CONCLUSION: Independent prognosis predictors of in-hospital pediatric CPR were the POPC score before CPR, the duration of CPR, and repeated CPR.
Bradycardia ; Cardiopulmonary Resuscitation* ; Cardiovascular Diseases ; Chungcheongnam-do ; Heart Arrest ; Humans ; Logistic Models ; Pediatrics ; Perfusion ; Prognosis* ; Prospective Studies ; Sample Size ; Shock ; Survival Rate

BACKGROUND: In brain ischemia, increased arachidonic acid metabolism can play important roles in neuronal dam-age. Ibuprofen was reported to have a protective role against neuronal damage in focal brain ischemia and reperfusion. The present study was designed to investigate whether ibuprofen can inhibit the global ischemia-induced neuronal dam-age and changes of polyamine (PA) level which is known to related to the neuronal damage, breakdown of blood brain barrier, and brain edema. METHODS: Male Mongolian gerbils were used in this study. Transient global ischemia was induced by occlusion of bilateral common carotid arteries for 3 min with microclips. Ibuprofen was administered imme-diately after ischemia. The animals were sacrificed one day after ischemia for PA measurement and sacrificed 5 days after ischemia for histological evaluation. Histological examination was performed by counting surviving neuronal cells in one mm of CA1 area in dorsal hippocampus. RESULTS: Cerebral cortex and hippocampal putrescine(PU) levels in vehicle-treated ischemic group significantly increased comparing to sham-operated animals and the increase of PU was attenuated by ibuprofen administration (50 mg/kg). Hippocampal spermine level decreased significantly after ischemia. Hippocampal neuronal cell damage in CA1 area was markedly observed in vehicle-treated animals compared to sham operated animals. Ibuprofen administration at the dose of 50 mg/kg significantly inhibited hippocampal CA1 neuronal damage compared to vehicle-treated animals. CONCLUSIONS: Ibuprofen attenuates PA response following transient glob-al ischemia and may have putative neuroprotective effect against neuronal damage induced by global ischemia.
Animals ; Arachidonic Acid ; Blood-Brain Barrier ; Brain Edema ; Brain Ischemia ; Carotid Artery, Common ; Cerebral Cortex ; Gerbillinae* ; Hippocampus ; Humans ; Ibuprofen* ; Ischemia* ; Male ; Metabolism ; Neurons* ; Neuroprotective Agents ; Reperfusion ; Spermine

BACKGROUND: Vestibular neuritis (VN) is a common peripheral vestibulopathy. VN is most likely a partial rather than a complete vestibular paralysis, It has a natural history of gradual recovery within 1-6weeks. The investigation of vestibulo-ocular reflex (VOR) change in acute and compensated VN are relatively few in Korea. We performed the vestibular function test including electronystagmography (ENG) and rotary chair test (RCT) in the patients with acute and compensated VN, and evaluated the efficacy of ENG and RCT to know the degree of compensation. METHODS: Tweenty-four patients with acute VN, 14 patients who had cllinically compensated VN during follow-up period and 30 normal controls were studied. Mean intervals from symptom onset to test were 3.6 days (acute) and 102.5 days (com-pensated). RESULTS: Eight patients had asymmetrically impaired pursuit, and ten patients had asymmetrcally impaired OKN during acute stage. The degree of side differences in pursuit and OKN gain was correlated with intensity of spon-taneous nystagmus. In the acute stage, the gain of the VOR was reduced at low frequency (0.01-0.16Hz), but it was normal at high frequency (0.32Hz). Prolonged phase lead and gain asymmetries were present at all range of frequency. In the compensated stage, the gain, phase and symmetry of the VOR at all range of frequency were not different from those of controls, except for prolonged phase lead and asymmetry at 0.01 Hz. The rate of the patients with unilateral canal paresis was 100% at acute stage and 50% at compensated stage in mono-thermal cold caloric stimulation. CONCLUSIONS: These results suggested that pursuit and OKN abnormalities may be found in acute peripheral vestibu-lopathy, in which coarse spontaneous nystagmus may contribute to the development of these abnormality. Absence of caloric response does not indicate an complete absence of vestibular function and RCT is a useful method in evaluation of VOR status in patients with acute and compensated VN.
Compensation and Redress ; Electronystagmography ; Follow-Up Studies ; Humans ; Korea ; Natural History ; Paralysis ; Paresis ; Reflex, Vestibulo-Ocular ; Vestibular Function Tests* ; Vestibular Neuronitis*

BACKGROUND AND OBJECTIVES: Sinusitis is frequently accompanied by severe orbital or intracranial complication which require a fast multidisciplinary therapy because a diagnostic delay may cause the patient's sequeles. We aim to evaluate the clinical features, radiologic findings, disease courses and therapy of sinogenic orbital complication. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 34 patients with sinogenic orbital complications from January, 2002 to December, 2007. The clinical features of the complication, the radiologic findings, admission duration and treatment given to the patients were evaluated. The prognosis of each case was set according to the Chandler's classification. RESULTS: Periorbital cellulitis is the most common complication and it is found more frequently in children (54.5%) than in adult (21.7%). The most common symptom of sinogenic orbital complication is periorbital edema. In addition, facial and orbital pain is a common symptom. We identified the frequency of involved sinus in sinogenic orbital complications as follows;maxillary sinus (85.3%), anterior ethmoid sinus (82.4%), posterior ethmoid sinus (64.7%), frontal sinus (50.0%) and sphenoid sinus (35.3%). In terms of treatment, endoscopic surgery was needed in most cases except for periorbital cellulitis. CONCLUSION: Rhinosinusitis patients who have headache and ocular pain in spite of medical treatment need to consider the possibility of sinogenic complications. And early diagnosis and adequate treatment are important to prevent severe orbital complications.
Adult ; Cellulitis ; Child ; Early Diagnosis ; Edema ; Ethmoid Sinus ; Frontal Sinus ; Headache ; Humans ; Medical Records ; Orbit ; Prognosis ; Retrospective Studies ; Sinusitis ; Sphenoid Sinus

Sarcoidosis is a multisystem disorder of unknown cause. The involvement of the nervous system occurs 5% to 27% of patients with sarcoidosis, and neurosarcoidosis without systemic involvement is rare and difficult to diagnose. We present a case of 58-year-old woman with clinical features of multiple cranial and peripheral polyneuropathy with noncaseating granulomatous inflammation. Extensive testing for occult systemic sarcoidosis was negative. Sural nerve biopsy showed several perineural noncaseous granulomatous inflammation with prominent epithelioid cells. Oral steroid therapy led to some improvement. We report a patient with multiple cranial and peripheral polyneuropathy without systemic involvement, suspected sarcoidosis.
Biopsy ; Cranial Nerve Diseases ; Epithelioid Cells ; Female ; Humans ; Inflammation ; Middle Aged ; Nervous System ; Polyneuropathies ; Sarcoidosis ; Sural Nerve