The authors report two cases of unusual chondrosarcoma, one in clavicle & the other in sacrum and reviewed literature.
Chondrosarcoma ; Clavicle ; Sacrum

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

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*

OBJECTIVE: This article was to review 10 years experience of cesarean hysterectomy at our hospital. To review risk factors, management & outcome of emergency peripartum hysterectomy performed in last 10 years at our hospital. MATERIAL & METHODS: The outcome of 33 cases of cesarean hysterectomy performed at St. Benedict hospital during 10 years from Jan. 1990 to Dec. 1999 was discussed & evaluated. RESULTS: During this time, there was 16014 deliveries, of which 5640 were cesarean section and 25 were cesarean hysterectomies, an incidence of 0.44%, and of which 10374 were vaginal deliveries 8 were. Cesarian hysterectomies are incidence of 0.08%. The age of patients varies from 18 to 42. The higher the age and the parity of patients, the higher incidence of cesarean hysterectomy was noted. The most common indication of cesarean hysterectomy was placental abnormal presentation [placenta accreta (30.3%), placenta previa (27.2%)], uterine atony (33.3%), uterine myoma with pregnancy (6.0%) and Uterine ruture (3.0%). The complication were febrile morbidity, disseminated intravascular coagulopathy and urinary tract injury. There was one maternal death. CONCLUSION: Postoperative complication still remain the causes of maternal morbidity. There careful prenatal care momentary judgement of right operation time, fresh whole blood transfusion and reduction of operation time must be conjunction with maternal life saving. Cesarean delivery, prior cesarean delivery placenta accreta and uterine atony were identified as risk factors for emergency peripartum hysterectomy and abnormal presentation was the primary cause of cesarean hysterectomy. Still, cesarean hysterectomy remains a potentially life saving procedure with which every obstetrician must be familiar.
Blood Transfusion ; Cesarean Section ; Emergencies ; Female ; Humans ; Hysterectomy* ; Incidence ; Leiomyoma ; Maternal Death ; Parity ; Peripartum Period ; Placenta Accreta ; Placenta Previa ; Postoperative Complications ; Pregnancy ; Prenatal Care ; Risk Factors ; Urinary Tract ; Uterine Inertia

Thallium(T1) has recently been used as a pharmaceutical for tumor imaging and staging. The aim of this study was to evaluate the clinical significance of the T1 analogue, 99m-Tc-MIBI(methoxyisobutylisonitrile), for imaging of intracranial lesions. The advantages of MIBI were though to be a lower radiation exposure and better image quality than with T1. 99m-Tc-MIBI SPECT studies were done in 30 patients with brain tumors(14 astrocytomas, 7 meningiomas, 2 hemangioblastomas, 2 craniopharyngiomas, 1 ependymoma, 4 metastatic tumors) and in twelve patients with non-tumorous lesions(2 abscesses, 2 granulomas, 2 cysticercosis, 3 old intracerebral hemorrages, 1 infarction. 1 postoperative gliosis, 1 unknown pathology), and semiquantitative assessment of tracer uptake was made using a ratio of radioactivity for lesion to contralateral normal brain(Lesion/Contralateral normal brains ; L/C). Twenty six of thirty tumors showed high L/C ratios(>1.5) and another four tumors low L/C ratios(<1.5). Of 12 non-tumorous intracranial lesions, 11 showed little or no uptake, but one moderate uptake. In conclusion, it appears that brain tumors show more intense focal uptake than non-tumorous brain lesions. However, further studies would be warranted to evaluate the clinical significance of MIBI SPECT in tumor staging(grading) and in differentiating necrosis from tumor regrowth more clearly.
Abscess ; Astrocytoma ; Brain ; Brain Neoplasms ; Craniopharyngioma ; Cysticercosis ; Ependymoma ; Gliosis ; Granuloma ; Hemangioblastoma ; Humans ; Infarction ; Meningioma ; Necrosis ; Radioactivity ; Thallium ; Tomography, Emission-Computed, Single-Photon*

OBJECTIVE: This study was designed to evaluate the efficacy and safety of tianeptine and sertraline in the treatment of patients with depression. METHOD: The study was done on the patients with major depression diagnosed by DSM-IV, who had a Hamilton Rating Scale for Depression(HAM-D) score > OR =14 on the first 17 items of the HAM-D. A total of 40 patients were randomly assigned to tianeptine group and sertraline group. Tianeptine and sertraline were prescribed to each group. 6 weeks of each medication was carried out after 7 days of drug excretion period. Evaluation using 17 item HAM-D, Montgomery and {0c5}sberg Depression Rating Scale(MADRS), Clinical Global Impression Scale(CGI), and Covi Scale was done on the baseline and after 1 week, 2 weeks, 4 weeks, and 6 weeks. Regarding all side effects that had occurred during the period of our study such as their developed/disappeared time, severities, incidences, managements and results have been recorded. RESULTS: A total of 30 patients(tianeptine group 15;sertraline group 15) finished the 6 weeks of research. 37.5mg of the daily dose was regularly prescribed to the tianeptine group, the average amount of 64.0+/-22.5mg of the final daily dose was prescribed to the sertraline group. Total 17 item HAM-D scores, total points of MADRS and CGI showed significant decrease after 1 week in each treatment group and continous decrease after 2, 4 and 6 weeks;and no difference was found between tianeptine group and sertraline group in the antidepressant efficacy. Also there were no significant changes in vital sign, CBC, chemistry, and EKG in each treatment group. The common reported side effects of tianeptine were nausea(33.3%), epigastic distress(26.7%), dry mouth(20.0%), headache(13.3%) and those of sertraline were dry mouth(53.3%), headache(46.7%), nausea(33.3%), anorexia(33.3%). CONCLULSION: According to the results, tianeptine was effective in improvement of depressive symptoms and was well tolerated and safe in patients with depression.
Chemistry ; Depression* ; Diagnostic and Statistical Manual of Mental Disorders ; Electrocardiography ; Humans ; Incidence ; Sertraline* ; Vital Signs

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

Mature cystic teratoma of the ovary is the most common ovarian germ cell tumor and benign, but malignant transformation occurs in less than 2% of benign mature teratoma. Of the malignancies arising in teratomas, squamous cell carcinoma is the most common, however, carcinoid tumors or adenocarcinomas arising in mature cystic teratoma are uncommon, especially simultaneously. We present an unusual case of premenopausal woman having carcinoid tumor and mucinous adenocarcinoma simultaneously arising in ovarian muture cystic teratoma.
Adenocarcinoma ; Adenocarcinoma, Mucinous* ; Carcinoid Tumor* ; Carcinoma, Squamous Cell ; Female ; Humans ; Mucins* ; Neoplasms, Germ Cell and Embryonal ; Ovary ; Teratoma*

Cases of intracranial complication following infections of head and neck have been reported rarely, but the case of intracranial complication following tubo-ovarian abscess has not been reported yet. In this case, the 35-year-old women patient with lower abdominal pain and mild headache that was diagnosed as pelvic inflammatory disease was admitted to our hospital and was cared. In the course of admission, headache was aggravated and lateral deviation of eyeballs occurred. She was diagnosed as intracranial abscess following tubo-ovarian abscess in the result of neurological surgery department consultation. So we report it with brief review of literatures.
Abdominal Pain ; Abscess ; Adult ; Brain Abscess ; Female ; Head ; Headache ; Humans ; Neck ; Ovary ; Pelvic Inflammatory Disease

Cases of intracranial complication following infections of head and neck have been reported rarely, but the case of intracranial complication following tubo-ovarian abscess has not been reported yet. In this case, the 35-year-old women patient with lower abdominal pain and mild headache that was diagnosed as pelvic inflammatory disease was admitted to our hospital and was cared. In the course of admission, headache was aggravated and lateral deviation of eyeballs occurred. She was diagnosed as intracranial abscess following tubo-ovarian abscess in the result of neurological surgery department consultation. So we report it with brief review of literatures.
Abdominal Pain ; Abscess ; Adult ; Brain Abscess ; Female ; Head ; Headache ; Humans ; Neck ; Ovary ; Pelvic Inflammatory Disease