Clinical observations of 11 cases of acute pyogenic osteomyelitls and 14 cases of acute pyogenic arthritis in infancy during past 11 years were carried out and following results obtained. 1. The highest age incidence was less than 3 months after birth (70.6%). 2. Average duration of symptoms was 7.8 days. 3. The most important underlying cause was multiple femorai vessel puncture (23.5%). 4. The chief symptom or sign on admission was pseudoparalysis or limitation of motion (82.4%), and local swelling (82.4%). But high fever on admission was present in only 29.4% of cases. 5. The femur was the most common site in acute pyogenic osteomyelitis (36.4%), and the hip joint in acute pyogenic arthritis (42.9%). 6. Leucocyte count was Increased more than 20,000/mm in 60.0% of the cases. Erythrocyte sedimentation rate was increased more than 21 mm/hr in 72.0% of cases. The positive result on bacteriologic culture was 76.0%. Coagulase-positive Staphylococcus aureus was cultured in 4 cases of acute pyogenic osteomyelitis and 5 cases of acute pyogenic arthritls. a-hemolytic Streptococcus was cultured in 2 cases of acute pyogenic osteomyelitls and 1 case of acute pyogenic arthritis. Hemophilus influenzae was cultured in 1 case of acute pyogenic osteomyelitls and 2 cases of acute pyogenic arthritis. 7. 45.5% of acute pyogenic osteomyelitis was combined with acute pyogenic arthritis. 8. The longer the duration of symptoms was, the longer the abnormal hematologic picture lasted. Erythrocyte sedimentation rate was the most accurate index of activity in acute infection of bone and joint. 9. Shortening or deformity due to epiphyseal plate damage occured in 1 case of acute pyogenlc osteo-myelitis, and 3 cases of acute pyogenic arthritis. Those complications could be minimized wlth early diagnosis and treatment.
Arthritis ; Blood Sedimentation ; Congenital Abnormalities ; Early Diagnosis ; Femur ; Fever ; Growth Plate ; Haemophilus influenzae ; Hip Joint ; Incidence ; Joints ; Osteomyelitis ; Parturition ; Punctures ; Staphylococcus aureus ; Streptococcus

Pulmonary artery sling is an uncommon and potentially lethal vascular anomaly that can produce airway obstruction. Despite the availibility of a corrective operation, the mortality rate remains very high due to the high incidence of associated obstructive anomalies of the tracheobronchial tree. We experienced a 70-day-old male infant who was admitted to our unit because of sudden dyspnea, cyanosis, coarse expiratory wheezing and inspiratory stridor. At first, he was treated with bronchodilator and steroid under the impression of infantile asthma, but the symptoms went on without interval change. We performed magnetic resonance imaging study followed esophagography and two dimensional echocardiography. Finally he was diagnosed as a vascular sling. We report this with a brief review and related literatures.
Airway Obstruction ; Asthma ; Cyanosis ; Dyspnea ; Echocardiography ; Humans ; Incidence ; Infant ; Magnetic Resonance Imaging ; Male ; Mortality ; Pulmonary Artery ; Respiratory Sounds

No abstract available.
Dementia* ; Epidemiologic Studies*

Lymphomatoid papulosis is a strange disease; clinically benign, histologically malignant. Clinically, it may simulate pityriasis lichenoides et varioliformis acuta. The diagnosis is based on the typical histopathological features suggestive of malignant lymphoma, due to the presence of polymorphous lymphoid infiltrate consisting of small lymphocytes intermingled with conspicuous large atypical cells. We experienced a case of lymphomastoid papulosis in 35-year-old woman. Initially, her skin lesions developed as erythematous papules on the extremities, gradually spreading centrifugally with a tendency to involute slowly without treatment, leaving brown wrinkled surface and shallow ulceration. These skin lesions tended to become worse in warm weather and better in cold weather. At first visit, multiple erythematous grouped, ulcerated papules and nodules are seen. 18 months after first visit, most skin lesions are regressed except 5 erythematous pinhead sized papules on right leg in spite of no treatrnent. Labcratory examiniations of CBC, VDRL, urinatlysis, blood chemistry and chest X-ray were all within normal limits. Histopathologically there were hygerkeratosis, mild acanthosis, exocytosis in epidermis, and numerous lymphoid cells were infiltrated especially on perivascular and periappendegeal area, and many atypical cells showing hyperchromatic nuclei, kidney-shaped nuclei and mitotic figures in dermis.
Adult ; Chemistry ; Dermis ; Diagnosis ; Epidermis ; Exocytosis ; Extremities ; Female ; Humans ; Leg ; Lymphocytes ; Lymphoma ; Lymphomatoid Papulosis* ; Pityriasis Lichenoides ; Skin ; Thorax ; Ulcer ; Weather

BACKGROUND: Prevention of postherpetic neuralgia as well as management of the symptoms of the acute stage is an important therapeutic goal in the treatment of herpes zoster. Corticosteroid, acyclovir and sympathetic block have all been advocated as effective therapeutic tools for the treatment of the disease. OBJECTIVE: This study was conducted to evaluate the necessity of sympathetic block for prevention of postherpetic neuralgia in acute herpes zoster. METHODS: The author observed the duration and degree of pain and the incidence of postherpetic neuralgia in 54 patients with herpes zoster treated with three different therapeutic measures. Group A was treated with triamcinolone acetonide 80mg three times, acyclovir and sympathetic blockade, group B with triamcinolone acetonide 80mg three times and acyclovir, and group C with triamcinolone acetonide 40mg three times and acyclovir. RESULTS: 1. Addition of sympathetic blockade to corticosteroid and acyclovir therapy did not seem to reduce the duration of pain and incidence of postherpetic neuralgia. 2. The Incidence of postherpetic neuralgia was higher in the elderly, especially with underlying systemic disease including diabetes melitus, hypertension, etc. Al] the therapeutic measures could not completely prevent the development of postherpetic neuralgia in those patients. 3. Regarding corticosteroid dosage, daily triamcinolone acetonide 80mg for three consecutive days showed no better effect than daily 40mg for consecutive days. CONCLUSION: When herpes zoster was treated with proper dosages of corticosteroid and acyclovir in its acute stage, sympathetic block showed no additional beneficial effect.
Acyclovir ; Aged ; Herpes Zoster* ; Humans ; Hypertension ; Incidence ; Neuralgia, Postherpetic ; Triamcinolone Acetonide

OBJECTIVES: Stigma of schizophrenic patient has a negative effect on the social adaptation of patients to return to society after proper treatment. This study showed the factors affecting the stigma recognized by schizophrenic patient and utilized them as the basic materials to overcome such stigma effectively. SUBJECTS AND METHOD: Total number of subjects were 318, including 278 patients who receive treatment of schizophrenia in NaJu National Hospital and 40 patients of Chonam University Hospital. The evaluation instrument of the stigma refers to 'Wording of Items in the Stigma Scale' developed by Bruce Link, translated into Korean and revised into 20 items after getting through preliminary study. It was consisted of three subscales including secret, prejudice and devaluation. Authors examined the subjects' demographical characteristics, clinical variables and degree of depression through Beck Depression Inventory. Observed were the correlation between these factors and the degree of stigma to understand the factors affecting the degree of stigma. RESULTS: This study showed that there was a significant differences in the degree of stigma according to occupation, degree of family support felt by patients, frequency of family visits and level of depression. In the degree of stigma according to occupation, students, farmers and the unemployee showed relatively higher stigma than professional technicians, especially in devaluation scale. The degree of family support felt by patients and frequency of family visits were reversely correlated with the degree of stigma. The level of depression was correlated with the degree of stigma. There is no significant difference in the degree of the whole stigma, but there is a significant difference in subscales according to the experiences of participation in disease education and treatment in hospitals. Patients who received no psychoeducation showed high scores in secret scale and patients of NaJu National Hospital had higher prejudice than patients of Chonam University Hospital. Such factors as sex, age, education, marital status, religion, residence, family economic status, frequency of hospitalization, experience of open ward, recent regular treatment and duration of illness did not show significant correlations with the degree of stigma. CONCLUSIONS: It is found that family support, regular occupation and frequent patient visits can be factors decreasing the stigma. Psychoeducation about mental illness is related to the reducing the tendency to hide the disease. In addition, coping with derpession can be helpful to reduce the stigma of patients and effective social adaptation.
Depression ; Education ; Hospitalization ; Humans ; Jeollanam-do ; Marital Status ; Occupations ; Prejudice ; Schizophrenia

Remarkable improvement in control of malignant tumor was achieved by combined surgery and postoperative radiation therapy. In Past, radiation therapy had been recommended after 4-6 weeks from operation because of worry about increased complication rate of surgical wound by post-operative irradiation. Nowadays, early surgical extirpation and early post-operative irradiation is recommended for better therapeutic effect. To evaluate the relationship between surgery-radiation interval and healing of surgical wound, an experimental study was undertaken using a total of 132 mice. A single dose of 2000 rads irradiation was delivered immediate after and on 1,3,5,10,14days after incision and suture on the skin of hind limbs of mice. Tensile strengths of the wounds were measured after removal of stitches on 1st, 3rd, 5th, 7th, 10th, 14th and 21st post-operative days. The results are summarized as follows; 1. Wound healing was delayed by irradiation delivered within 3 days from operation. 2. No significant delay of wound healing was observed by irradiation on 5 or more days after operation. 3. Normal wound strength was attained at 21st post-operative day in any surgery-radiation interval. 4. More severe delay of wound healing by irradiation at 24 hrs after operation than by immediate post-operative irradiation although statistical significance is not confirmed. In conclusion, early post-operative irradiation delays healing of the surgical wound though ultimately tensile strength reaches the value of non-irradiated wound.
Animals ; Extremities ; Mice ; Radiation Effects ; Skin ; Sutures ; Tensile Strength ; Wound Healing ; Wounds and Injuries

No abstract available.
Posterior Cruciate Ligament*

OBJECTIVE: To evaluate the effects of piroxicam patch(Trast) in rheumatoid arthritis patients with knee joint pain and swelling and to determine the concentration of plasma and synovial fluid following patch application. METHODS: Twenty-two patients with rheumatoid arthritis participated in a double-blind, placebo-controlled study. The patients were instructed to apply piroxicam or placebo patch at one knee and re-apply it every other day for 2 weeks. They had washout period for 2 weeks and then applied the other patch for 2 weeks at the same joint. The patients recorded knee joint pain using visual analog scale. Knee joint swelling and tenderness were assessed before and after application of piroxicam and placebo patch. Complete blood count, AST, ALT, BUN, creatinine, joint fluid analysis were also done. Piroxicam concentration in plasma and synovial fluid were measured by high performance liquid chromatography(HPLC) after 2 weeks of piroxicam patch application. RESULTS: Knee joint pain improved significantly after the application of piroxicam patch for 2 weeks(visual analog scale, 56. 2+5. 9m vs 48. 2+5. 7mm, p=0. 03 by Wilcoxon signed rank test). There was no significant change in white cell count of synovial fluid, peripheral blood cell count, chemistry, C-reactive protein and erythrocyte sedimentation rate. In terms of adverse effects, mild gastrointesti nal disturbance(8/21 cases, 38%) and local side effects such as pruritus and ery thema(3/21 cases, 14%) were developed, which were insignificant compared with control groups(30%, 15% respectively). Piroxicam concentrations in plasma and synovial fluid after the application of piroxicam patch were 0. 129+0. 04ug/ ml (mean+SE) and 0. 644+0. 202ug/ml respectively. CONCLUSIONS: Piroxicam patch is a safe and effective therapeutic modality for knee joint pain in patients with rheumatoid arthritis. Mild adverse effects such as gastrointestinal disturbance and local side effects were noted. Piroxicam concentration was higher in synovial fluid than in plasma following the application of piroxicam patch.
Arthritis, Rheumatoid* ; Blood Cell Count ; Blood Sedimentation ; C-Reactive Protein ; Cell Count ; Chemistry ; Creatinine ; Humans ; Joints ; Knee ; Knee Joint ; Piroxicam ; Plasma ; Pruritus ; Synovial Fluid ; Visual Analog Scale

Biomarkers of suicidal behavior (SB), particularly peripheral biomarkers, may aid in the development of preventive and intervention strategies. The peripheral biomarkers of SB should be easily accessible, cost-effective, and minimally invasive. To identify peripheral biomarkers of SB, we summarized the current knowledge related to SB biomarkers with a focus on suicidal outcomes (suicidal ideation [SI], suicide risk [SR], suicide attempt [SA], and suicide death [SD]), measured site (center or periphery), and study design (cross-sectional or longitudinal). We also evaluated the central findings to validate the findings of peripheral biomarkers of SB. We found reduced peripheral interleukin (IL)-2 levels in individuals with a recent SA, higher cerebrospinal fluid (CSF) IL-6 levels in patients with a current SR and future SD, higher CSF tumor necrosis factor-α levels for current and future SRs, higher high-sensitivity C-reactive protein levels and lower peripheral total cholesterol levels for recent SAs, lower peripheral 5-HT levels for present SR, and a lower folate level for future SR and SA within 1 year. Previous studies have shown inconsistent associations of low peripheral leptin levels with SR and recent SA; therefore, further study is required. Given the multiple determinants of SB and weak associations with single biological markers, combinations of potential biological markers rather than single markers may improve the screening, diagnosis, and prediction of SB.