OBJECTIVES: The purpose of this study was to assess the clinical features, microbiologic results, and the efficacy of perineal hygienic care of pediatric vulvovaginitis. METHODS: Forty-two unselected premenarcheal patients with symptoms or signs of vulvovaginitis who were attended the outpatient pediatric and adolescent gynecology clinic at Pundang CHA General Hospital from August 1997, to September 1999 were systematically interviewed and examined using a standardized format, studied microbiologically, and followed the efficacy of perineal hygienic measures prospectively. RESULTS: The median age of the patients was 4.8 years (range 2.9 years to 10.9 years). Vaginal complaints of 42 patients were discharge(79%), genital pain or irritation(31%), odor(17%), pruritus(14%), and vaginal bleeding(7%). On physical examination, vaginal discharge and vulvar erythema were noted in 17(40%) and 22(52%) patients, respectively. Aerobic bacteria or yeast excluding vaginal normal flora were found in 24 of 42 patients(57%). Convincing evidence of specific pathogens was found in 9 of 42 patients(21%) including one case of pinworm infestation. Isolated pathogens were H. influenza(3), S. pyogenes(2), K. pneumonia(2) and N. gonorrhea(1). No patients were found to have chlamydial infection or trichomoniasis. In 14 patients, risk factors were identified such as swimming(14%), bubble bath(5%), sexual abuse(5%), genital trauma(5%) and foreign body(2%). After two weeks instructions of perineal hygienic care, 26(62%) of 42 patients revealed complete resolution of symptoms and signs of vaginitis without antibiotics. Efficacies of perineal hygienic care were 94%(17/18) in the patients with normal flora alone, 60%(9/15) in the patients with organisms suspected for nonspecific infection and 0%(0/9) in the patients with specific pathogens(p<0.05). CONCLUSION: Majority(62%) of the pediatric patients with symptoms or signs of vulvovaginitis were cured with perineal hygienic care alone. And the efficacy of hygienic measure were higher in the patients without specific pathogens(79%, 26/33). Therefore, proper physical examination, microbiologic study and appropriate instructions of perineal hygienic care were more important than empirical antibiotic treatment in initial management of pediatric vulvovaginitis.
Adolescent ; Anti-Bacterial Agents ; Bacteria, Aerobic ; Enterobius ; Erythema ; Gynecology ; Hospitals, General ; Humans ; Outpatients ; Physical Examination ; Prospective Studies ; Risk Factors ; Vaginal Discharge ; Vaginitis ; Vulvovaginitis* ; Yeasts

INTRODUCTION: There are insufficient researches about the causes and the actual condition of fracture in Hansen's disease. Hence, I would like to indicate the problem by analysing the actual condition of fractures in Sorocdo Hansen's disease and a link between electromotion scooter and fracture. MATERIAL AND METHODS: Object is 75 patients who were admitted at Sorocdo National Hospital due to fracture from 2003, January to 2006, December. The medical record was analysed by retrospectively. Patient's general feature and the feature related to accident were analysed. Moreover, use of electromotion scooter and the relation between them were researched. RESULTS: The proportion of males to females is 1.41:1. Average age is 73.6 and over 65 years old shows 78.7%(59 persons) which means fracture happens frequently at old age. Predominant percentage of fracture is occurred at summer(34.7%) and autumn(33.4%). In addiction, the number of fracture patients is increased surprisingly since electromotion wheelchair and scooter were introduced in 2005. Hip joint fracture(34.7%) and distal radius fracture (16.0%) are the main region. The major reasonsof fracture are falls(52.2%) and accidents related to electromotion scooter(17.9%). The mortality of patients who were treated surgically(4.9%) is meaningfully lower than that who received conservated treatment(23.5%). CONCLUSION: The aged population and the number of electromotion scooter are been increasing in Sorocdo. Therefore, We need to find the fundamental and specific measure to prevent fracture caused by falls and electromotion scooter accident. Furthermore, surgical treatment is required actively.
Female ; Hip Joint ; Humans ; Leprosy ; Male ; Medical Records ; Mortality ; Radius Fractures ; Retrospective Studies ; Wheelchairs

External fixators are popular in treatment of the open fractures of long bones, especially tibia, associated with soft tissue injury, because they prevent further injury to the injured soft tissue and bone. Over the past ten years, bilateral frame external fixtors such as Hoffmann system had been used for lower extremity lesions. But they had many disadvantages like that bilateral frames were less rigid in A-P plane bending moment mechanically, therefore unilateral frame external fixators such as Monofixateur have been introduced recently. The Monofixateur was able to fix the fracture rigidly and compress, distract and neutralize the fracture site and could be used as a static and dynamic stabilizer. We have treated 19 cases using Monofixateur of the Gotzen type for open fractures of lower extremity from October 1984 to Febrary 1987. The summary of the results obtainained from this study are as follows : 1. Monofixateur was easy to use, simple and light. It provided a rigid stability to fracture. 2. It was possible to allow static stabilization on the unstable fracture, whereas dynamic stabilization on the stable fracture. 3. Application was easier than any other type of external fixators from the view point of using a few screws and unilateral frame, therefore it could prevent further soft tissue injury and was easy to secondary operation. 4. It was possible to use for short fracture fragment of the proximal or distal fractures of the long bone. 5. The fracture healing time averaged 32.5 weeks and there were marked differences of the fracture healing time between open type I, II and III fractures. 6. There was little complication such as pin tract infection and ankylosis of the joint.
Ankylosis ; External Fixators ; Fracture Healing ; Fractures, Open ; Joints ; Lower Extremity ; Soft Tissue Injuries ; Tibia

No abstract available.
Chylothorax*

No abstract available.
Humans

Various kinds of bone cements mixed with antibiotics have been widely used for treatment and prevention of infections, especially combined with bone defects. But bone cements have some disadvantages in that they are rather expensive and capable of incurring some complications such ss fibrosis of surrounding soft tissue or local erosion of bone, and furthermore, they must be removed after infection is controlled for bone graft to fill up the defects because they do not have properties of osteoconduction or osteoinduction. So we have come to the idea of using theoretically advantageous plaster of paris to take place of bone cements, and performed in-vitro experiment upon the effectiveness of plaster of paris pellets containing antibiotics, then obtained good results comparable to those from many experimental studies using bone cements. By this, we think that it would be possible in the future to treat and prevent infections supervening bone defects with plaster of paris mixed up with antibiotics. The results are as follows : 1. Sustained release of large amount of antibiotics from plaster of paris enough to exert inhibitory activity on abcterial growth, and there was a direct relationship between concentrations of eluted antibiotics and diameters of inhibitory zones. 2. Tobramycin was capable of inhibiting the growth of S. aureus, E. coli, and Ps. aeruginosa for 7 days at maximum. 3. Cephradine inhibited the growth of S. aureus and E. coli but did not affect that of Ps. aeruginosa. 4. The maximum antibacterial activity wss reached within first 24 hours from the start of elution of antibiotics from plaster of paris.
Anti-Bacterial Agents ; Bone Cements ; Bone Regeneration ; Calcium Sulfate ; Cephradine ; Fibrosis ; Tobramycin ; Transplants

STUDY DESIGN: We report two cases of symptomatic spinal epidural lipomatosis (SEL) associated with long-term use of steroid medication OBJECTIVES: The purpose of this study was to assess the clinical characteristics, diagnosis and treatment of symptomatic spinal epidural lipomatosis. SUMMARY OF LITERATURE REVIEW: Spinal epidural lipomatosis is a condition in which excess adipose tissue is deposited circumferentially about the spinal cord in the epidural space. It can present neurologic symptoms including back pain, radiculopathy or cauda equina. Magnetic resonance imaging is the most helpful dignostic means and should be used initially if suspected. Treatment is decompressive laminectomy and debulking of fat. MATERIALS AND METHODS: Two cases of lumbar epidural lipomatosis with neurologic symptoms were discussed and evaluated by physical examination, postmyelography CT and MRI. RESULTS: Two cases were treated with decompressive laminectomy and debulking of fat. Increased accumulation of the fatty tissue was seen predominently in posterior and posterolateral epidural space of the spinal canal, displacing and compressing the lumbar spinal cord anteriorly. Both gross and histologic evaluation revealed overgrowth of unencapsulated normal appearing fat consistent with spinal epidural lipomatosis. One case was demonstrated gradual improvement in symtoms after operation but the other was died due to medical problems. CONCLUSION: The authors reviewed the literature and reported the results of operative treatment of patients with lumbago, radicular pain and intermitent claudication caused by epidural lipomatosis of lumbar spine and degenerative spinal stenosis.
Adipose Tissue ; Back Pain ; Cauda Equina ; Diagnosis ; Epidural Space ; Humans ; Laminectomy ; Lipomatosis* ; Low Back Pain ; Magnetic Resonance Imaging ; Neurologic Manifestations ; Physical Examination ; Radiculopathy ; Spinal Canal ; Spinal Cord ; Spinal Stenosis ; Spine

No abstract available.
Leukemia*

INTRODUCTION: The acute abdomen define as an acute abdominal condition which needs immediate decision for treatment. The retrospective study was conducted to evaluate the characteristic of the acute abdomen in Hansen's disease. MATERIALS AND METHODS: An analysis was made of the records of 53 patients in surgical department at the National Soocdo Hospital from January, 2003 through December, 2005 for 3 years. RESULTS: The sex ratio of male to female was 1:1.04, and the mean age was 75.1 years. The most prevalent age group was in between 71 to 75 years of age(24.5%). Common diseases of acute abdomen were gastrointestinal bleeding(28.3%), acute appendicitis(17.0%), biliary tract disease(15.1%), intestinal obstruction(15.1%) in order of frequency. The operation rate was 32.1%(17 case). As for operative procedure, appendectomy was done in 9 cases, cholecystectomy was done in 3 cases, subtotal gastrectomy was done in 2 cases , palliative gastrectomy and gastric primary closure with omental patch and adhesiolysis with small bowel primary closure was done in 1 case each. The overall mortality rate was 24.5%(13 case). CONCLUSION: Gastrointestinal bleeding and intestinal obstruction was more frequent than other old age group. The operation rate was low, and the mortality rate was high. This study suggests that more active and surgical treatment need in acute abdomen of Hansen's disease patients.
Abdomen, Acute* ; Appendectomy ; Biliary Tract ; Cholecystectomy ; Female ; Gastrectomy ; Hemorrhage ; Humans ; Intestinal Obstruction ; Leprosy* ; Male ; Mortality ; Retrospective Studies ; Sex Ratio ; Surgical Procedures, Operative

Pulmonic autograft replacement of the aortic valve (Ross procedure) has been to have potential for growth in children, no complication of antiocagulation, and enhanced durability. Therefore, Ross operation is indicated in the young, in patients with an active life style, and when anticoagulation is contraindicated. However, late autograft valve has occurrd more frequently in patients with significant size discrepancy between the pulmonay valve annulus and the aortic valve annulus. In order to resolve this problem, we performed aortic annuloplasty with Duran ring for more accurate and strong reinforcement. We report a case using the Duran ring as a method of aortic annuloplasty during Ross procedure.
Aortic Valve ; Autografts ; Child ; Humans ; Life Style