We had a retrospective study for taumatic fracture of spines with simple X-ray and CT. During the period of 2years from June 1983, the radiological and clinical evaluation had been made on 36 patients suffered from traumatic fracture of spines which were confiremd by the radilgocial examination. The results were as follows; 1.Among 36 patients, single spinal injury was 26 cases(72.2%), multiple level injuries was 10 cases(27.7%). 2. Levelof spinal injuries were as follows; Most frequent site was thoracolumbar junction (T11-L2) in 19 cases(52.7%), andlower cervical spine(C3-C7) in 9 cases(25%). 3. Simple fracture was in 15 cases(41.6%), burst fractures was in 21cases(58%). Neurologic symptoms were appeared in 11 cases(52%) in 21 cases of burst fractures. 4. Manifestationsof spinal canal narrowing: 2 of 15 cases in simple fracture, all of 21 cases of burst fractures,and we were foundexactly posterior element fractures with CT, which were difficult to detect with simple X-ray film. 5. Multiplanar reconstruction images were more favorable to detect the distraction of facet joint, fracture through the vertebralendplate, subluxation and kyphosis, which were difficult to detect with axial CT images.
Humans ; Kyphosis ; Neurologic Manifestations ; Retrospective Studies ; Spinal Canal ; Spinal Fractures ; Spinal Injuries ; Spine ; X-Ray Film ; Zygapophyseal Joint

There are many procedures for treatment of injuries of acromioclavicular separation, but still controversies concerning the best management of these injuries. From March 1981 to August 1984 at Masan Korea Hospital, twelve cases were treated by technique of modified Phemister method, two cases by Dewar and Barrington method, two cases by Stewart method, one case by Neviaser method, three cases by skillful neglect method and two cases by shoulder harness immobilization. The following results were obtained. 1. These injuries were more prevalent in male and more in right side. 2. The most common cause of injuries was traffic accident and followed by falling from the height. 3. Three cases were grade 2 and nineteen cases grade 3 by Allman's classification. 4. We treated these injuries by operative method in seventeen cases and non-operative method in five cases. 5. There were good functional results of treatment in operative method. 6. There were two cases of superficial wound infection, two cases of migration of K-wire and one case of recurrence of deformity in operative method, and two cases of shoulder stiffness and 2 cases of recurrence of deformity in non-operative method.
Accidental Falls ; Accidents, Traffic ; Acromioclavicular Joint ; Classification ; Congenital Abnormalities ; Humans ; Immobilization ; Korea ; Male ; Methods ; Recurrence ; Shoulder ; Wound Infection

The neutron beam has higher relative biological effectiveness (RBE) than conventional X or gamma ray because it is densely ionizing radiation which is presented by high linear energy transfer (LET). This physical and radiobiological characteristic plays an important role in killing of cancer cells in the state of biologically radio-resistant to the conventional radiation. The rationale of high LET radiation in the application to clinical radiotherapy is summarized as, high oxygen enhancement ratio (OER), less repair of cell damage, and less dependence of radio-sensitivity on cell cycle. Neutron therapy alone or combined with conventional radiotherapy was performed in 12 patients with stage C or D1 prostatic cancer from Mar. 1987 to Dec. 1989 in Korea Cancer Center Hospital. Local control rate at the time of 24 months after therapy was 67% (4/6) in stage C and 67% (4/6) in stage DI. Two-year actuarial survival rate after therapy was 82% in stage C and 67% in stage D1. The problem of neutron therapy was relatively high incidence of major complication rate, but it could be lessened by the accumulation of experience for neutron therapy. We think neutron therapy to be one of adequate treatment modalities for local control of stage C or Dl prostatic cancer.
Cell Cycle ; Gamma Rays ; Homicide ; Humans ; Incidence ; Korea ; Linear Energy Transfer ; Neutrons* ; Oxygen ; Prostatic Neoplasms* ; Radiation, Ionizing ; Radiotherapy ; Relative Biological Effectiveness ; Survival Rate

Giant pigmented nevus is a variety of congenital melanocytic nevi, and may be associated with various abnormalities, such as skeletal malformation, lipoma, vascular nevi, melanosis in the meninges, meningocele, and intracranial arteriovenous malformation. We report a case with congenital giant pigmented nevus and porencephaly. This association should be considered as the spectrum of neurocutaneous syndromes related to congenital giant pigmented nevus.
Intracranial Arteriovenous Malformations ; Lipoma ; Melanosis* ; Meninges ; Meningocele ; Neurocutaneous Syndromes ; Nevus ; Nevus, Pigmented*

Torsade de pointes is a life-threatening, polymorphic ventricular tachycardia associated with prolongation of the QTc interval. Although torsade de pointes is found in many clinical settings, it is mostly drug induced. Similar problems have been described with nonsedating H1-selective antihistamines like terfenadine and astemizole. The increased risks of both H1-antihistamines were associated with exposure to supratherapeutic doses or concomitant exposure to the cytochrome P-450 inhibitors, ketoconazole, erythromycin and cimetidine. We report a 51-year-old woman with torsade de pointes and a long QTc interval caused by the combined use of terfenadine and itraconazole. After discontinuation of these drugs and treatments with electrical cardioversion and magnesium sulfate, torsade de pointes and prolonged QTc interval were no longer observed and she was discharged in good condition with a normal ECG. In conclusion, physicians should be aware that terfenadine and astemizole can cause torsade de pointes in rare cases.
Astemizole ; Cimetidine ; Cytochrome P-450 Enzyme System ; Electric Countershock ; Electrocardiography ; Erythromycin ; Female ; Histamine Antagonists ; Humans ; Itraconazole* ; Ketoconazole ; Magnesium Sulfate ; Middle Aged ; Tachycardia, Ventricular ; Terfenadine* ; Torsades de Pointes*

Infantile hypertrophic pyloric stenosis(IHPS) is one of the most common causes of nonbilious vomiting in early infancy, and is caused by hypertrophied pyloric muscle but its exact etiology and pathogenesis are still unknown. Fredet-Ramstedt pyloromyotomy has been accepted as the treatment of choice for IHPS. Atropine is a cholinergic blocking agent with potent antimuscarinic activity that decreases peristaltic contractions by relaxing smooth muscles. We treated a case of IHPS in a 33-day-old male infant by administering atropine sulfate intravenously. One day after atropine sulfate administration, he did not vomit any more. Ultrasonograms of the pyloric canal which were done on eight days and three weeks after atropine treatment revealed no limitation in the passage of gastric content, and no changes in the muscle thickness and length of the pyloric canal. Thereafter, he did not show up at follow ups, we received his mother's answer through phone that he did not suffer from vomiting and he was growing well at 5 months of age.
Atropine* ; Follow-Up Studies ; Humans ; Infant ; Male ; Muscle, Smooth ; Pyloric Stenosis, Hypertrophic* ; Ultrasonography ; Vomiting

Necrotizing fasciitis is a rare, but life-threatening infection. Prompt diagnosis and early aggressive intervention is required for survival. However, there has been frequently occurred in delays of diagnosis and treatment due to its non-specific nature. Therefore, a high index of suspicion is needed to ensure timely intervention. We report a case of necrotizing fasciitis in a 7-day-old term healthy neonate.
Dietary Sucrose ; Fasciitis, Necrotizing ; Humans ; Infant, Newborn

People with type 2 diabetes mellitus have increased risk of chronic kidney disease and atherosclerotic cardiovascular disease. Improved care delivery and implementation of guideline-directed medical therapy have contributed to the declining incidence of atherosclerotic cardiovascular disease in high-income countries. By contrast, the global incidence of chronic kidney disease and associated mortality is either plateaued or increased, leading to escalating direct and indirect medical costs. Given limited resources, better risk stratification approaches to identify people at risk of rapid progression to end-stage kidney disease can reduce therapeutic inertia, facilitate timely interventions and identify the need for early nephrologist referral. Among people with chronic kidney disease G3a and beyond, the kidney failure risk equations (KFRE) have been externally validated and outperformed other risk prediction models. The KFRE can also guide the timing of preparation for kidney replacement therapy with improved healthcare resources planning and may prevent multiple complications and premature mortality among people with chronic kidney disease with and without type 2 diabetes mellitus. The present review summarizes the evidence of KFRE to date and call for future research to validate and evaluate its impact on cardiovascular and mortality outcomes, as well as healthcare resource utilization in multiethnic populations and different healthcare settings.

PURPOSE: Tuberculosis may cause a serious complication in children with cancer who are receiving the chemotherapy. But its diagnosis is not easy if we do not suspect the disease in patients with uncontrolled persistent fever. We studied retrospectively the importances of prevention and early diagnosis of tuberculosis in cancer patients. METHPDS: Twelve patients were diagnosed as having tuberculosis during cancer chemotherapy in Kyungpook National University Hospital from May, 1981 to May, 1998. We reviewed their clinical features, diagnostic methods, treatment and prevention. RESULTS: The median age of the patients was 14 (2~18) years. The underlying diseases were seven acute lymphoblastic leukemia (ALL), two acute undifferentiated leukemia (AUL), one acute nonlymphoblastic leukemia (ANLL), one mixed-lineage leukemia, and one Burkitt's lymphoma. The disease categories of tuberculosis were seven pulmonary tuberculosis, two tuberculous pleurisy, one miliary tuberculosis, one bone and endotracheal tuberculosis and one tuberculous meningitis. The family history of tuberculosis is positive in one case. The clues of the suspicion of tuberculosis infections were 9 cases of persistent fever despite broad spectrum of antibiotics and/or antifungal agent therapy, 2 chronic cough and 1 chest pain. We could diagnose four by AFB culture, three cases by AFB smear, two by polymerase chain reaction (PCR), one by pleural biopsy, one by transbronchial lung biopsy and one by chest X-ray and CSF study. We treated pulmonary tuberculosis and tuberculous pleurisy by triple therapy (isoniazid, rifampin, pyrazinamide) and miliary, bone, endotracheal tuberculosis and tuberculous meningitis by quadriple therapy (isoniazid, rifampin, pyrazinamide, streptomycin or kanamycin). The mean duration of defervescence after treatment was 15.4 days. One died of fulminant hepatitis probably by hepatitis B after completion of cancer chemotherapy, one died of adult respiratory distress syndrome, two died of DIC, three died of relapse of underlying disease, but no one died of tuberculosis infection itself. CONCLUSION: The early diagnosis of tuberculosis is an important factor for decreasing the mortality rates of cancer patients, so we should have a suspicion of this disease in patients with persistent fever in spite of appropriate antibiotic and antifungal agents. Isoniazid prophylaxis may be needed in childhood cancer patients with chemotherapy in Korea.
Anti-Bacterial Agents ; Antifungal Agents ; Biopsy ; Burkitt Lymphoma ; Chest Pain ; Child ; Cough ; Dacarbazine ; Diagnosis ; Drug Therapy* ; Early Diagnosis ; Fever ; Gyeongsangbuk-do ; Hepatitis ; Hepatitis B ; Humans ; Isoniazid ; Korea ; Leukemia ; Leukemia, Myeloid, Acute ; Lung ; Mortality ; Polymerase Chain Reaction ; Precursor Cell Lymphoblastic Leukemia-Lymphoma ; Pyrazinamide ; Recurrence ; Respiratory Distress Syndrome, Adult ; Retrospective Studies ; Rifampin ; Streptomycin ; Thorax ; Tuberculosis* ; Tuberculosis, Meningeal ; Tuberculosis, Miliary ; Tuberculosis, Pleural ; Tuberculosis, Pulmonary

A survey was conducted to determine the extent of intestinal parasite infection in Bat Dambang, Cambodia in March 2004. A total of 623 fecal specimens was collected from kindergarten and schoolchildren and examined using the formalin-ether sedimentation technique. The overall infection rate of intestinal parasites was 25.7% (boys, 26.2%; girls, 25.1%), and the infection rates of intestinal helminthes by species were as follows: Echinostoma sp. 4.8%, hookworm 3.4%, Hymenolepis nana 1.3%, and Rhabditis sp. 1.3%. The infection rates of intestinal protozoa were; Entamoeba coli 4.8%, Giardia lamblia 2.9%, Iodamoeba butschlii 1.4%, Entamoeba polecki 1.1%, and Entamoeba histolytica 0.8%. There were no egg positive cases of Ascaris lumbricoides or Trichuris trichiura. All children infected were treated with albendazole, praziquantel, or metronidazole according to parasite species. The results showed that intestinal parasites are highly endemic in Bat Dambang, Cambodia.
Adolescent ; Age Factors ; Animals ; Cambodia/epidemiology ; Child ; Feces/parasitology ; Female ; Helminthiasis/*epidemiology ; Helminths/isolation & purification ; Humans ; Intestinal Diseases, Parasitic/*epidemiology ; Male ; Protozoa/isolation & purification ; Protozoan Infections/*epidemiology