No abstract available.
Fingers*

Leg length discrepancy in the growing children was developed by multiple causes; such as congenital, infection, traumatic, and mechanical facotrs etc. The discrepancy have been treated by several methods including bony lengthening which is preferable method, but epiphysiodesis also has been one of the valuable methods in which was applied to the treatment of mild to moderate leg length discrepancy in the growing children. We report on patients(15 cases) with leg length discrepancy treated by percutaneous epiphysiodesis since July 1986. There were 8 males and 7 females and the average age of them was 12.6 years old. And we also performed an experimental study which was to find out the effectiveness of the pereutaneous physeal destruction comparing the techningues between curette and drill in the bony models. The causes of leg length discrepancy were trauma in 8 cases and osteomyelitis in 2 cases, congenital dislocation of the hip in 2 cases, poliomyelitis, Legg-Galve-Perthes disease, congenital hemihypertropy in each 1 case. The average preoperative leg length discrepancy was 2.6cm(range:1.9-3.7cm), and average anticipated discrepancy without operation have been 3.7cm(range:2.2-6.3cm) at maturity. The final discrepancy was 0.9cm after 43 months follow-up. According to the result by experimental study, percutaneous epiphysiodesis with curette technique would be more effective and safe than drill thchnique. Percutaneous epiphysiodesis might be one of the useful methods for the treatment of mild to moderate degree of leg length discrepancy in the growing children, and also could be applied combining with bony lengthening for treatment of severe degree of leg length discrepancy.
Child ; Dislocations ; Female ; Follow-Up Studies ; Hip ; Humans ; Leg ; Male ; Methods ; Osteomyelitis ; Poliomyelitis

PURPOSE: To describe the clinical presentation and course of necrotizing fasciitis of low extremity and to analyze the factors affecting the clinical result of necrotizing fasciitis. MATERIALS AND METHODS: The medical records and MRI of 26 patient who had suffered from necrotizing fasciitis were reviewed retrospectively. RESULTS: There were 18 men and 8 women with a mean age of 43.8 years. Twenty two of 26 patients had a medical disease and the most common comorbidity was diabetes mellitus. Exquisite pain, erythema, warm skin were the most consistent clinical feature at the time of admission. Only six patients had a diagnosis of necrotizing fasciitis initially. The interval between onset of symptom and operative treatment was average 5.4 days in 20 patients who didn't have a diagnosis of necrotizing fasciitis initially, and among them, 2 patients died. There were limited range motion of knee joint in 3 cases, sacral osteomyelitis in 1 case, and sciatic nerve palsy in 1 case as a complication. CONCLUSION: We think that the diagnosis of necrotizing fasciitis should be considered with a high index of suspicion in patients who present with unexplained limb pain, and delay in operative treatment and wide involvement of the necrosis is associated with poor results of necrotizing fasciits.
Comorbidity ; Diabetes Mellitus ; Diagnosis ; Erythema ; Extremities* ; Fasciitis, Necrotizing* ; Female ; Humans ; Knee Joint ; Magnetic Resonance Imaging ; Male ; Medical Records ; Necrosis ; Osteomyelitis ; Retrospective Studies ; Sciatic Neuropathy ; Skin

BACKGROUND: Introduction of automation instruments for the blood bank is essential in order to reduce inspection error and minimize workload. We compared the results of ABO-RhD blood type and antibody screening tests using the manual method and those using the automation instruments AutoVue Innova (Ortho-Clinical Diagnostics, Raritan, NJ, USA) and QWALYS-3 (DIAGAST, Loos Cedex, France). METHODS: ABO-RhD blood type tests using the slide method, the tube method, and the instruments were performed with 200 selected samples. Antibody screening tests using the Ortho BioVue system (Ortho-Clinical Diagnostics, Raritan, NJ, USA), which is used in our laboratory, and the two instruments were performed with 188 specimens and 12 antibody positive samples that were kept in the laboratory. We evaluated the concordance rate of the results, applying CLSI guideline EP12-A2. RESULTS: The concordance rate of ABO-RhD blood type results between the manual methods and the two instruments was 100%. On antibody screening tests, a concordance rate of 100% was observed between the manual method and AutoVue Innova, which uses the gel card manufactured by the company making the gel card used for the manual method. However, using QWALYS-3 in performance of antibody screening tests, the concordance rate was 97.5%, because of discordance in five specimens. CONCLUSION: The concordance rate of ABO-RhD blood type by use of two automation instruments was 100%, however, that of the antibody screening test was 97.5%. Thus, there was a difference in positive rate on the antibody screening test, depending on the instrument. Therefore, introduction of an instrument, considering the pros and cons for each instrument, is necessary. In addition, further discussion of standardized guidelines for quality control is needed.
Automation ; Blood Banks ; Cephalosporins ; Mass Screening ; Quality Control

Early esophageal cancer is defined as a tumor invading the mucosa with or without lymph node or distant organ metastasis. In the current guidelines for early esophageal cancer, absolute indication for endoscopic resection include lesions limited to the epithelium or lamina propria mucosa not exceeding two-thirds of the circumference, and relative indications include lesions limited to the muscularis mucosa or the upper third of the submucosal layer and not accompanied by clinical evidence of lymph node metastasis. After endoscopic submucosal dissection for early esophageal cancer, locally recurrent cancer can occur, especially in the case of incomplete resection. Here, we report a rare case of a submucosal tumor-like recurrence after endoscopic resection of early esophageal cancer.
Endosonography ; Epithelium ; Esophageal Neoplasms ; Lymph Nodes ; Mucous Membrane ; Neoplasm Metastasis ; Recurrence

Female ; Forced Expiratory Volume ; Humans ; Linear Models ; Lung ; Male ; Radiography, Thoracic ; Spirometry ; Vital Capacity

The number of persons with HIV infection in Korea have increased steadily, total number of HIV infection in Korea were 478 on August, 1995. To investigate the clinicoimmunologic manifestation of AIDS in Korea, we reviewed complete blood counts (CBC), CD4 counts, serum beta2-microglobulin level, opportunistic infections and cause of death for 19 AIDS patients who had been admitted or visited at Pusan national university hospital during the period of January, 1990 to August, 1995. 1) The predominant mode of HIV transmission was heterosexual contact(18), other modes of transmission were homosexual contact(1). Clues of diagnosis of HIV infection were routine occupational health examination(14), and opportunistic infection symptoms such as fever, coughing(4). 2) Mean CD4 cell counts(/mm3) were 53 +/- 72 totally, 22 +/- 27 for 8 dead patients at mean 2 month before, 91 +/- 87 for 7 living patients. There were not significant difference(p>0.05). 3) Serum beta2-microglobulin(MG;ug/ml) was measured at 12 patients, mean serum beta2-MG level was4.8 +/- 7.3 totally, 7.1 +/- 10.3 for 6 dead patients at mean 1.3 month before, 2.5 +/- 0.4 for 6 living patients. There were not significant(p>0.05). 4) At CBC examination, WBC(/mm3) was 5,932 +/- 2,899 totally, 5,452 +/- 3,436 for 10 dead patients, 6,500 +/- 2,221 for 9 living patients(p>0.05). Hb(g/dl) was 11,4 +/- 2.8 totally, 9.4 +/- 1.8 for dead patients, 13.6 +/- 1.8 for living patients(p<0.05). Lymphocyte count(/mm) was 1,255 +/- 800 totally, 731 +/- 424 for dead patients, 1,838716 for living patients(p<0.05). ESR(mm/h) was 72 +/- 47 totally, 97 +/- 33 for dead patients, 47 +/- 47 for living patients(p<0.05). 5) Opportunistic infections had developed at 14 patients, candidiasis 7, pneumocystis carinii pneumonia 5, tuberculosis 3, cytomegalovirus infection 2, herpes zoster 3, toxoplasmosis 1, cryptococcal infection 2, bacterial pneumonia 5, and herpes simplex l. Malignant lymphoma had developed in 1 patient. 6) Mean survival interval from diagnosis of HIV infection to death was 32.8 +/- 19.1 months, and the most common cause of death was pneumocystis carinii pneumonia, and other causes of death were meningitis, bacterial pneumonia and AIDS-wasting syndrome. Based on these results, We concluded that CD4 counts, serum beta2-microglobulin level, Hb, total lymphocyte count and ESR in AIDS patients are specific laboratory markers of progression and prognosis of AIDS, the most common opportunistic infection was candidiasis, and the most common cause of death in AIDS patients was pneumocystis carinii pneumonia.
Biomarkers ; Blood Cell Count ; Busan ; Candidiasis ; Cause of Death ; CD4 Lymphocyte Count ; Cytomegalovirus Infections ; Diagnosis ; Fever ; Herpes Simplex ; Herpes Zoster ; Heterosexuality ; HIV ; HIV Infections ; Homosexuality ; Humans ; Korea ; Lymphocyte Count ; Lymphocytes ; Lymphoma ; Meningitis, Bacterial ; Occupational Health ; Opportunistic Infections* ; Pneumonia ; Pneumonia, Bacterial ; Pneumonia, Pneumocystis ; Prognosis ; Toxoplasmosis ; Tuberculosis

BACKGROUND/AIMS: Although only a few sporadic cases of Q fever have been reported in Korea, a total of 13 cases have been seen in our area. We performed this study to evaluate the clinical characteristics of these cases of acute Q fever. METHODS: Demographic features, clinical manifestations, laboratory and radiologic findings, and therapeutic outcomes of all cases were evaluated. Q fever was diagnosed using an indirect micro-immunofluorescence assay (MIFA) and polymerase chain reaction (PCR). RESULTS: A total of 13 patients with acute Q fever seen from January 2006 to August 2008 at three teaching hospitals in the Daegu Metropolitan City area were enrolled. The mean age was 49 years old (range, 24~76), and the male to female ratio was 11:2. Six (46.2%) cases had a history of animal contact. Fever (100%) was the most common manifestation, followed by myalgia (84.6%), headache (61.5%), anorexia (61.5%), and chills (61.5%). All cases were diagnosed with high titers of anti-phase II antibody (IgM> or = 1:50, IgG> or =1:200) and positive nested PCR for the 27-kDa OMP com-1 gene of Coxiella burnettii in the blood. In three cases, liver biopsies revealed the presence of compact fibrin-ring granulomas. No characteristics of pneumonia were diagnosed on chest X-rays. The predominant presentation was acute febrile illness with hepatitis, including three cases (27.3%) of severe cholestatic hepatitis. The most frequently used antimicrobial agent was doxycycline (84.6%), followed by azithromycin (7.7%). CONCLUSIONS: Acute Q fever may be added to the list of differential diagnosis of patients with acute febrile illness and hepatitis in the Daegu Metropolitan City area.
Animals ; Anorexia ; Azithromycin ; Biopsy ; Chills ; Coxiella ; Diagnosis, Differential ; Doxycycline ; Female ; Fever ; Granuloma ; Headache ; Hepatitis ; Hospitals, Teaching ; Humans ; Korea ; Liver ; Male ; Pneumonia ; Polymerase Chain Reaction ; Q Fever ; Thorax

The guidelines for chronic obstructive pulmonary disease (COPD) treatment are important for the management of the disease. However, studies regarding the treatment adherence to the Global Initiative for Chronic Obstructive Lung Disease (GOLD) guidelines have been scarce in Korea. Therefore, to examine the adherence to the GOLD guidelines, we examined the patterns of prescribed medication in COPD patients from 2011 to 2018. Patients were classified as having been appropriately and inappropriately treated (overtreatment or undertreatment) for the GOLD group. Appropriate medical therapy was defined as using the first choice or alternative choice drug recommended in the GOLD guidelines. Inappropriate therapy was classified as overtreatment or undertreatment in accordance with the categorization in the GOLD guidelines. According to treatment of 2011 GOLD guidelines, there was inappropriate treatment in 52.3% in group A, 47.3% in group B, 56.3% in group C, and 17.8% in group D. According to treatment of 2017 GOLD guidelines, there was inappropriate treatment in 66.7% in group A, 45.3% in group B, 14.3% in group C, and 24.0% in group D. The common type of inappropriate COPD treatment is overtreatment, with inhaled corticosteroid (ICS) containing regimens. In conclusions, adherence to the GOLD guideline by the pulmonologist in clinical practice is still low in Korea. Therefore, we need better strategies to both optimize the use of the guidelines and adhere to the guidelines as well.
Humans ; Korea* ; Lung Diseases ; Medical Overuse ; Pulmonary Disease, Chronic Obstructive*