Since Maisonneuve mentioned osteomyelitis complicated by typhoid fever for the first time in 1835, numerous investigators had reported salmonella osteomyelitis. The authors recently experienced six cases of salmonella osteomylitis: four cases in lumbar spine and the remainders in bones adjacent to elbow. Four cases were in adult male ranging from 18 to 35 years old and the others were in a male, age of thirteen and female, age of seven in elbow respectively. The two among four spondylitic cases and two cases of long bone ostemyelitis were surgically treated, and the other two spondylitic cases were conservatively treated. Salmonella osteomylitis was confirmed in surgically treated group by culture of pus obtained from pathologic lesion, and conservatively treated group was diagnosed by history, clinical manifestation, laboratory data and especially characteristic progress of roentgenographic change. The causative organisms were paratyphoid group D in all cases. Review of literature was done with report of six cases of salmonella osteomyelitis.
Adult ; Elbow ; Female ; Humans ; Male ; Osteomyelitis ; Research Personnel ; Salmonella ; Spine ; Suppuration ; Typhoid Fever

PURPOSE: To observe MR findings of vascular abnormality in Sturge-Weber syndrome and to determine the value of MRI in diagnosis. MATERIALS AND METHODS: Ten patients with Sturge-Weber syndrome (age : 3 months-32 years)were evaluated by MR imaging ; in six and four cases, respectively, the results were correlated with those of CT and angiography. We retrospectively analysed changes in the cortical vein and deep venous system, including the medullary and subependymal vein, as well as an largement of the choroid plexus, leptomeningeal enhancement, and changes in diploic space. RESULTS: In all cases except one, in which non-contrast enhanced study had been performed, varying degrees of leptomeningeal enhancement were seen. In nine cases the cortical vein became smaller; enlargement of the choroid plexus was seen in eight cases, change in the diploic space in seven (including three in which there was angiomatous involvement), and enlargement of the deep venous system in seven. In younger patients, collateral pathways were less developed and leptomeningeal angiomatous changes were more pronounced than in those who were older. CONCLUSION: MRI is a useful modality for the evaluationn of vascular changes in Sturge-Weber syndrome. These changes vary according to a patient's age and the duration of the disease.
Angiography ; Choroid Plexus ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Retrospective Studies ; Sturge-Weber Syndrome* ; Veins

Understanding depth of anesthesia is essential for the anesthesiologist. Although electroencephalogram (EEG) has been proposed and studied as a method of determining anesthetic depth, major limitations restrict its usefulness. For example, spectral edge frequency (SEF) dose not correlate well with the level of sedation. However, recently introduced bispectral index (BIS) which is derived from frequency, amplitude and coherence of the EEG is strongly correlated with clinical measurements of sedation and hypnosis. BIS monitoring may be used to guide the titration of anesthetic agents to achieve effective dosing without increasing the risk of awareness and to allow a better balance of hypnotic and analgesic administration. We report two cases of successful BIS monitoring for the measurement of intraoperative hypnotic state of patient during propofol target controlled infusion (TCI).
Anesthesia ; Anesthesia, General* ; Anesthetics ; Electroencephalography ; Humans ; Hypnosis ; Propofol*

PURPOSE: We evaluated the functional outcome as degeneration of articular surface of the patella after total knee arthroplasty without resurfacing the patella. MATERIALS AND METHODS: From 2002 to 2003, 63 cases of 52 osteoarthritis patients who underwent total knee arthroplasty without resurfacing the patella as randomized selection were evaluated. Average age was 67.2 years old. Female were 49 patients, and male 3 patients Average follow-up periods were 32 months. Used implant were all PFC-sigma. Clinical outcomes was analyzed as Feller's patella score (perfect score; 30 points), anterior knee pain, crepitation according to the extent of involvement of articular surface of the patella and patello-femoral tracking. RESULTS: The Feller's patella score increased from mean 20.1 to 26.9 (p<0.05). However, there were no statistically significant differences as extent of involvement of patello-femoral joint (p>0.05). The patella score was low with patellar malalignment. Anterior knee pain after operation increased during postoperative 6 months according to the extent of degeneration of patellofemoral joint, but after 6 months there is no statistically significant differences except group 4 and all groups gradually decreased. Crepitation was increased during postoperative 1 year according to the extent of cartilage degeneration and after that its incidence decreased with time. CONCLUSION: The clinical results of total knee arthroplasty without resurfacing the patella was not influenced by the extent of degeneration of patello-femoral joint, but by alignment of patellofemoral joint. Anterior knee pain and crepitation increased in proportion to the extent of degeneration of patello-femoral joint in early period, but it fade out with time.
Arthroplasty ; Cartilage ; Female ; Follow-Up Studies ; Humans ; Incidence ; Joints ; Knee ; Male ; Osteoarthritis ; Patella ; Patellofemoral Joint ; Track and Field

There are no previous large scale studies which have evaluated the phenotypes and clinical characteristics of Korean Crohn's disease patients who underwent intestinal resection. The purpose of this multicenter retrospective cohort study was to evaluate the clinical characteristics of Korean Crohn's disease patients who underwent intestinal resection during the study period. A total of 686 patients were enrolled in this study. The study period was over a 20-yr period (1990-2009). The patients were divided into the first-10-yr group and the second-10-yr group. The phenotypes and clinical characteristics were compared between the groups. The most common site of the disease was the ileal area (37.8%) and stricturing behavior was observed in 38.3% patients. The most common type of surgery was segmental resection of the small bowel (30.6%). These phenotypes showed a similar pattern in both the first and second study period groups and did not show any significant differences between the groups. The number of registered patients increased continuously. The phenotypes of Korean Crohn's disease patients who underwent intestinal resection are different compared with previously reported clinical characteristics of general Crohn's disease patients.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Asian Continental Ancestry Group ; Child ; Child, Preschool ; Cohort Studies ; Colon/surgery ; Crohn Disease/pathology/*surgery ; Female ; Humans ; Ileum/surgery ; Male ; Middle Aged ; Phenotype ; Republic of Korea ; Retrospective Studies ; Young Adult

OBJECTIVE: Trisomy 21 (Down syndrome) is the most common chromosomal anomaly which occurs 1 out of 700-1000 birth. Current techniques such as amniocentesis, chorionic villi sampling (CVS), require lengthy laboratory culture procedures and high costs. This study was undertaken to establish a rapid prenatal diagnosis of trisomy 21 using real-time quantitative polymerase chain reaction of fetal DNA from amniotic fluid. METHODS: Real-time quantitative PCR was performed with DNA template obtained from 14 normal serum, 10 normal amniotic fluid samples, 14 Down syndrome serum, and 7 Down syndrome amniotic fluid samples. Primers for D21S167 and S100B of chromosome 21 were used. Primers that direct amplification of 165-bp fragment of the IGFI (Insulin-like growth factor-1) gene on chromosome 12 are included to generate an internal standard for quantitation. RESULTS: The relative levels of D21S167 and S100B were 2.6 and 2.4 times higher in the serum of Down syndrome patients compared to the control group. The difference between these two groups was statistically significant (P-value: 0.0012 and 0.0016). The relative levels of D21S167 and S100B were 2.1 and 2.7 times higher in the amniotic fluid of Down syndrome fetuses compared to control group. The difference between these two groups was statistically significant (P-value 0.0379 respectively). CONCLUSION: Prenatal diagnosis of trisomy 21 by real-time quantitative PCR-associated STR (small tandem repeats) analysis of D21S167 and S100B is useful, accurate and rapid diagnostic method and also can be employed in diagnosis of trisomy 13, 18. Furthermore, it may also be useful for prenatal diagnosis with fetal DNA from maternal blood and for preimplantation genetic diagnosis.
Amniocentesis ; Amniotic Fluid ; Chorionic Villi Sampling ; Chromosomes, Human, Pair 12 ; Chromosomes, Human, Pair 21 ; Diagnosis ; DNA ; Down Syndrome* ; Female ; Fetus ; Humans ; Parturition ; Polymerase Chain Reaction* ; Pregnancy ; Preimplantation Diagnosis ; Prenatal Diagnosis* ; Trisomy*

PURPOSE: Abdominal pain is one of most common complaints in children who visit emergency department (ED), but sometimes it is very difficult in differential diagnosis between medical and surgical disease. This study was performed to collect and analysis of diagnositic scores of children with abdominal pain who could not definitely diagnosed as medical or surgical disease in ED. METHODS: This study reviewed 201 children who were visited for abdominal pain in ED at a tertiary hospital from January 2005 to June 2005. We reviewed the medical records and analysed clinical characteristics, laboratory findings, and radiologic findings retrospectively. We analyzed the diagnostic scores between medical and surgical disease group. RESULTS: The number of medical disease are 125 patients, and the number of surgical disease are 76 patients. Significant predictable factors for surgical diseases are right quadrant pain, vomiting, tenderness, rebound tenderness, leukocytosis and diagnostic score. The mean diagnostic score of medical diseases is 4.55+/-4.10 (mean+/-SD) and the mean score of surgical diseases is 16.22+/-3.48(mean +/-SD). CONCLUSION: For the diagnosis of children with abdominal pain which is uncertain either medical or surgical disease in ED, the diagnostic scores, careful observation and physical examination repeatedly are helpful for correct diagnosis and prompt treatment.
Abdominal Pain* ; Child* ; Diagnosis ; Diagnosis, Differential ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Leukocytosis ; Medical Records ; Physical Examination ; Retrospective Studies ; Tertiary Care Centers ; Vomiting

OBJECTIVES: This 6-week, open label randomized, multicenter study was conducted to evaluate the antidepressant effect and safety of milnacipran and fluoxetine in patients with major depression. METHODS: The study was done in patients with major depression diagnosed by DSM-IV who score > or =17 in 17 items Hamilton Rating Scale for Depression (17-item HAM-D) and score > or =25 in Montgomery and Asberg Depression Rating Scale (MADRS). A total of 87 patients were randomized to milnacipran group and fluoxetine group. In cases of the patients taking other antidepressants, 6 weeks of each medication was administered after 7 days of drug excretion period. The evaluation was done using 17 item HAM-D, MADRS, Clinical Global Impression Scale (CGI), and COVI scale after baseline, 1 week, 2 weeks, 4 weeks, and 6 weeks. The side effects that had occurred during the period of our study were put in records by developed/disappeared time, severities, incidences, managements and results. RESULTS: A total of 87 patients were enrolled. 70 (milnacipran group 39;fluoxetine group 31) of them were included for the 6 weeks of research and 17 of them dropped out within the first week, not due to adverse reactions or deficiency of effects. Total 17 item HAM-D scores, total points of MADRS, and CGI showed significant decrease after 1 week in each treatment group and continued decrease after 2 weeks and 4, 6 weeks. But there was no difference between milnacipran group and fluoxetine group in the antidepressant effect. There were no significant changes in vital sign, CBC, chemistry, and EKG in each treatment group. The commonly reported side effects of minlacipran were nausea (25.0%), headache (10.7%), vomiting (7.1%), constipation (7.1%), dizziness (7.1%) and those of fluoxetine were GI trouble (11.1%), diarrhea (11.1%), insomnia (11.1%), agitation (5.6%), and dizziness (5.6%). CONCLUSION: Milnacipran was effective for the improvement of depressive symptoms and was well tolerated and safe in patients with depression.
Antidepressive Agents ; Chemistry ; Constipation ; Depression* ; Diagnostic and Statistical Manual of Mental Disorders ; Diarrhea ; Dihydroergotamine ; Dizziness ; Electrocardiography ; Fluoxetine* ; Headache ; Humans ; Incidence ; Nausea ; Sleep Initiation and Maintenance Disorders ; Vital Signs ; Vomiting