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.

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*

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

The records of 15 cirrhotic patients with ascites and groin hernias(14 inguinal and one femoral) were retrospectively reviewed. Fifteen patients underwent repair of their groin hernias. All patients were performed herniorrhaphies electively. No major and one minor(wound infection) postoperative complications occurred. There were no perioperative deaths or ascitic leak. All patients were available for follow-up. In this group, 7 deaths occurred after herniorrhaphy, 5 of 7 were Child's Class B and 2 of 7 were Child's Class C. In this same group of patients, mean alive duration were 25.7 month(4-89 months). From this retrospective study, it appears that serious complications from groin hernias in cirrhotics are not common, and elective repair can usually await control of ascites. Additionally, for appropriately selected patients with ascites, elective inguinal hernia repair can be performed safely, with an acceptable rate of recurrence.
Ascites* ; Fibrosis* ; Follow-Up Studies ; Groin ; Hernia ; Hernia, Inguinal ; Herniorrhaphy* ; Humans ; Liver Cirrhosis ; Liver* ; Postoperative Complications ; Recurrence ; Retrospective Studies

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

BACKGROUND: Cancer of the esophagus is one of the most malignant tumors with poor prognosis. The p53 gene alteration, over expression of Cyclin D1, and Ki67 index were thought to be the prognostic factors. However, their clinical significances in esophageal squamous cell carcinoma are controversial and p53 accumulation may not correlate with genetic mutation. The current study investigates their prognostic significance in squamous cell carcinoma of the esophagus. MATERIAL AND METHOD: The Subjects studied were 124 esophageal squamous cell carcinoma patients who underwent esophagectomy. The mutation of p53, over expression of Cyclin D1, Ki67 labelling index, mitotic index were examined by using an immunohistochemical staining. We compared the results and investigated the correlation with the mutation of p53, overexpression of Cyclin D1, Ki67 labelling index, mitotic index and tumor size, and duration of survival. RESULT: There was no correlation between the results in immunohistochemical staining according to age, sex, tumor size, lymph node status, and clinical stage of the disease. Mutant p53 protein was found in 69 cases (55.6%). Median survival time was 21 months in cases with negative for mutant p53 protein and 22 months in positive cases. There was no significant difference in survival (p=0.46). Median survival time was 22 months in cases with negative for Cyclin D1 and 16 months in positive cases (p=0.18). Median and mean survival time was 22 months and 36 months when Ki67 labeling index was 40 or less (102 cases). Median and mean survival was 16 months and 23 months, when Ki67 labeling index was more than 40 (22 cases). There was significant difference in survival rate (p=0.011). CONCLUSION: Positivity of p53 and cyclin D1 was not useful in predicting the prognosis in our study. There was no significant correlation among mutant p53 protein accumulation, Cyclin D1 over expression, and Ki67 labeling index. However, in several studies, PCR single strand conformational polymorphism analysis of p53 showed a correlation to the prognosis. We thought that there was a significant discordance between p53 gene mutation and mutant p53 protein accumulation. When Ki67 labeling index was more than 40, prognosis was poorer. Ki67 seems to be a prognostic factor in our study. Therefore, we confirmed the possibility of using molecular markers as prognostic factors.
Carcinoma, Squamous Cell* ; Cyclin D1* ; Cyclins* ; Esophageal Neoplasms ; Esophagectomy ; Esophagus ; Genes, p53 ; Humans ; Lymph Nodes ; Mitotic Index* ; Polymerase Chain Reaction ; Prognosis* ; Survival Rate