No abstract available.
Alcoholism*

Tuberculosis of the bone and joints is either one of the generalized manifestation or solitary localized lesion. The involvement of bone after Bacille Calmette Guerin (BCG) vaccination is very rare. We experienced a case of which developed tuberculous osteomyelitis after BCG vaccination. The case is a 14-month-old male. The patient had the history of BCG vaccination 1 year ago. The presenting symptoms were swelling, redness and discharge of the left shoulder. The lesion in the left proximal humerus was mainly erosive lesion with minimal periosteal reaction. We are going to report a case of 14-month-old child with tuberculous osteomyelitis after BCG vac-cination with brief review of literature.
Child ; Humans ; Humerus* ; Infant ; Joints ; Male ; Mycobacterium bovis* ; Osteomyelitis* ; Shoulder ; Tuberculosis ; Vaccination*

Twelve patient with fracture of the neural arch of the axis (hangman's fracture or traumatic spondylolisthesis of the axis) were treated at Kangnam St. Mary's Hospital between 1980 and 1986. There were three type I fractures, seven type II fractures, and two type III fracture. Non of these patients had neurological damage. Seven patients (five in type II and two in type III) in this series, underwent anterior interbody fusion operation between axis and third cervical vertebra following 6 weeks of cervical traction. The remaining five patients were treated conservatively by cervicel traction in the bed. Average follow up period was 24 months. The mean duration of fracture union was 10 weeks after trauma in 3 cases of type I and twelve weeks after trauma in 2 cases of type II which were treated conservatively. Otherwise in 5 cases of type II and two cases of type III which were taken anterior interbody fu sion, the mean duration of fracture union was 8 weeks in type II and 10 weeks in type III after surgery. All regained a stability of the cervical spines. Because the fracture healing of the neural arch invariably occurred through this study, it is felt that anterior interbody fusion between axis and third cervical vertebra is necessary surgical.procedure to gain the early stability if there is an evidence of persistant instability between axis and third cervical verbebrae even after 6 weeks of conservative traction treatment.
Follow-Up Studies ; Fracture Healing ; Humans ; Spine ; Spondylolisthesis ; Traction

No abstract available.

Peritoneal dialysis (PD) has been utilized for the children with end stage renal disease. Nevertheless, it is thought to promote inguinal hernia by increasing intraabdominal pressure. To investigate the clinical characteristics of inguinal hernia in children on PD, 155 cases of PD in children between January 1996 and June 2007 at Seoul National University Children's Hospital were reviewed retrospectively. Inguinal hernia developed in 16 cases (10.3%, M:F=8:8). Hernia occurrence was not correlated to age. Eleven cases (69%) of inguinal hernia developed in first 6 months after initiation of PD. All inguinal hernias were surgically repaired. No complications occurred related to inguinal hernia or surgery. Recurrent hernia developed in 1 patient (6.3%) of 2 cases who had PD postoperatively on the day of surgery. In conclusion, inguinal hernia developed more frequently with children on PD than general population (3.5~5%). The rate of hernia development was highest within the first 6 months following initiation of PD. After repair of hernia, we recommend to discontinue PD immediate postoperatively to prevent recurrence.
Child ; Hernia ; Hernia, Inguinal ; Humans ; Kidney Failure, Chronic ; Peritoneal Dialysis ; Retrospective Studies

Catheter related and perianal problems are common surgical complications encountered during the treatment of pediatric malignancies. However acute surgical abdominal emergencies are rare. The aim of this study is to review acute surgical abdominal complications that occur during the treatment of childhood malignancies. Out of a total of 1,222 patients who were newly diagnosed with malignant disease, between January 2003 and May 2008, there were 10 patients who required surgery because of acute abdominal emergencies. Their medical records were reviewed retrospectively. Hematologic malignancies were present in 7 patients (4 leukemia, 2 lymphoma, 1 Langerhans cell histiocytosis) and solid tumors in 3 patients (1 adrenocortical carcinoma, 1 desmoplastic small round cell tumor, 1 rhabdomyosarcoma). Seven patients had intestinal obstruction, two had gastrointestinal perforation and one, typhlitis. Intestinal obstructions were treated with resection of the involved segment with (N=2) or without (N=3) enterostomy. Two patients had enterostomy alone when resection could not be performed. Intestinal perforation was treated with primary repair. Typhlitis of the ascending colon was treated with ileostomy. Right hemicolectomy was necessary the next day because of the rapidly progressing sepsis. Three patients are now alive on chemotherapy and one patient was lost to followed-up. Among six patients who died, five died of their original disease progression and one of uncontrolled sepsis after intestinal perforation. Although rare, acute surgical abdominal complications can occur in childhood malignancies. Rapid and accurate diagnosis and appropriate operation are required for effective treatment of the complications.
Abdomen ; Adrenocortical Carcinoma ; Catheters ; Child ; Colon, Ascending ; Desmoplastic Small Round Cell Tumor ; Disease Progression ; Emergencies ; Enterostomy ; Hematologic Neoplasms ; Humans ; Ileostomy ; Intestinal Obstruction ; Intestinal Perforation ; Leukemia ; Lymphoma ; Medical Records ; Retrospective Studies ; Sepsis ; Typhlitis

The usefulness of totally implantable central venous port for long-term intravenous infusion is widely accepted in children. Usually the catheters are placed through the internal or external jugular vein. In case of jugular vein cut-down, two separate incisions are needed for catheter and port respectively. Patients also feel uncomfortable as the catheter run through the neck. However these disadvantages can be overcome by using the cephalic vein (CV). We reviewed our experiences on CV cut-down for totally implantable central venous port in children. From January 2002 to December 2006, 201 patients (M:F=127:74) underwent 218 central venous port insertions. Mean age at operation was 5.9 years (2 months - 19 years). Indications included chemotherapy (N=167), long-term intravenous antibiotics infusion (N=36), and total parenteral nutrition (N=15). CV was selected preferentially. The incision includes the deltopectoral triangle laterally, and both the CV cut-down and port insertion were achieved with a single incision. The number of insertion through external, internal jugular vein, and CV was 77, 66 and 75, respectively. The median age, height and body weight were higher in CV cut-down group. The youngest age for CV cut-down was 8 months, the shortest height was 69 cm and the smallest body weight was 5.9 kg. Of 118 trials of CV cut-down, cut-down was successful in 75 cases (63.6 %). CV was absent in 10 cases(8.4 %) and CV was sacrificed after catheter tip malposition in 10 cases (8.4 %). There was only one complication, in which the catheter was inserted into the minute branch of subclavian artery. The CV cut-down method for totally implantable central venous port was safe and feasible in selected groups of patients in children. In addition, preservation of jugular vein and a more favorable cosmetic effect are other benefits of CV cut-down.
Anti-Bacterial Agents ; Body Weight ; Catheterization, Central Venous ; Catheters ; Child ; Cosmetics ; Humans ; Infusions, Intravenous ; Jugular Veins ; Neck ; Parenteral Nutrition, Total ; Subclavian Artery ; Veins ; Venous Cutdown

PURPOSE: We designed this study to demonstrate recent trends in the proportion of adult hip research in orthopedics, to identify countries leading the adult hip research, and to evaluate the relationship between the economic power of the countries and their contributions. MATERIALS AND METHODS: Studies published in seven select orthopedic journals were retrieved from PubMed. Among them, we determined the number of adult hip studies. The countries-of-origin of adult hip studies, and the economic power of the countries were investigated. RESULTS: A total of 7218 orthopedic publications and 1993 (27.6%) addressed adult hip research were identified. Adult hip studies increased from 313 (23.7%) in 2000 to 555 (27.9%) in 2011. Twenty-five countries accounted for 97.6% of the total number of adult hip studies, and gross domestic product correlated with publication volume (Spearman's rho, 0.723; p=0.000). CONCLUSION: Researchers from a limited number of developed countries have published their studies in the adult hip discipline.
Adult ; Geography ; Hip/*physiology ; Humans ; PubMed ; Publications/*trends ; Research/*trends

During pregnancy profound immunologic, metabolic, endocrine, and vascular changes occur. Because of these changes, some diseases are affected by pregnancy. These diseases can aggravate or improve during pregnancy. Lymphomatoid papulosis is a continuing self-healing eruption whose lesions are clinically benign but histologically contain malignant-appearing cells. We report a case of lymphomatoid papulosis which developed in 30-year-old pregnant woman. And we discussed the possible association between lymphomatoid papulosis and pregnancy.
Pregnancy ; Female ; Humans

Over 26 kinds of tablets and capsules, such as Tetracycline, Quinidine and Potassium preparations were reported to cause esopbageal ulcerations, eharacterized in various size, shape and number, ind sually in mid-esophagus, Recently authors experienced 10 cases of drug-induced esophageal ulcerations due to antibiotics and antiinflammatory agents such as Tetracycline, Aspirin, etc. Four cases were men and six were women. Four cases were in third dades, three in fourth cleeades, two in fifth decades and one in sixth decades. Presenting symptoras were odynophagia(4/10), dysphagia(3/10), substernal pain(7/10) and epigastric pain(3/10). Endoscopic examination of the esophgus showed single or multiple, small and shallow ulcers on the mid-esophgeal mucosa at the level of 30cm from the ineisor in eight cases, one Iarge and deep ulcer at the level of 40cm from incisor in one patient and one amall, shallow and one large, deep ulcers at the same time. in one patient The shape of alcers were various from a round to a large horseshoe shaped one. The clinical course was mild without complications. It was suggested that drug-induced esophsgeal ulcers with antibiotics and antiinflammatory agents could be found frequently and they had benign and mild clinicalc ourse,
Anti-Bacterial Agents ; Anti-Inflammatory Agents ; Aspirin ; Capsules ; Female ; Humans ; Incisor ; Male ; Mucous Membrane ; Potassium ; Quinidine ; Tablets ; Tetracycline ; Ulcer*