PURPOSE: This study aimed to explore how prevalent the community-related methicillin-resistant Staphylococcus aureus (CA-MRSA) was in children with muscular-skeletal infections. METHODS: We retrospectively reviewed the medical records of patients of 18 years or under who were diagnosed with suppurative arthritis or osteomyelitis and S. aureus from September 2000 through August 2012 at the CHA Bundang Medical center. RESULTS: Thirty-one cases of suppurative arthritis or osteomyelitis were identified. The patients were between 17 days old and 18 years old with an average age of 7. Eleven cases (33.5%) of suppurative arthritis and 16 cases (51.6%) of osteomyelitis were observed. Five cases were accompanied by the two diseases. Methicillin sensitive S. aureus (MSSA) was isolated in 25 cases (80.6%) and methicillin resistant S. aureus (MRSA) was isolated in 6 cases (19.4%). Multidrug resistant strains were not observed. MRSA was not found from 2000 through 2005. All patients were treated with antibiotics and the duration of antibiotics treatment was 26.4+/-12.7 days. Vancomycin was used as the initial antibiotic treatment in 4 cases (12.9%) and vancomycin was used as the definitive antibiotics in the 10 cases (32.3%). CONCLUSIONS: The result of this study showed that methicillin resistance rate of S. aureus from muscular-skeletal infections was concentrated in the latter half of the 12 year period.
Anti-Bacterial Agents ; Arthritis, Infectious ; Child ; Humans ; Medical Records ; Methicillin ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Osteomyelitis ; Retrospective Studies ; Vancomycin

PURPOSE: The purpose of this study is to investigate the clinical manifestations and antibiotic resistance of salmonellosis in children. METHODS: We reviewed medical records and investigated the clinical characteristics of culture-proven childhood salmonellosis from January 2000 through December 2011 at the CHA Bundang Medical center. RESULTS: We assessed 53 patients. The median age was 3-years-old (minimum 12 days, maximum 18-years-old) and the number of male patients was 33 (62.3%). It occurred most frequently in the summer (39%) and in 2001 (11 cases) however there was no case in 2009 and 2010. Salmonella typhi was isolated in 3 cases with septicemia. Antibiotic resistance to ampicillin was most frequently presented (30.2%) and 63.6% in serogroup B. No antibiotics resistance strains were cultured in patients with positive Salmonella typhi. Admitted patients from 2000 to 2011 were divided into 2 groups; group 1 from 2000 to 2005 and group 2 from 2006 to 2011. 40 cases belonged to group 1 and 13 cases were in the group 2. Group 2 showed more resistance to ampicillin than group 1 but without any statistical significance(25% vs. 38.5%, P=0.349). In group 1, the most common serotype was group D and in group 2, the most common serotype were group C and D. CONCLUSION: Salmonellosis in children was frequently occurred from 2000 to 2003 but decreased after 2004. There was no difference in clinical manifestations, serotypes and antibiotic resistances between the years.
Ampicillin ; Anti-Bacterial Agents ; Child ; Drug Resistance, Microbial ; Humans ; Male ; Medical Records ; Salmonella Infections ; Salmonella typhi ; Sepsis

No abstract available.
Peptides*

Erdheim Chester disease (ECD) is very rare non-Langerhans cell histiocytosis (LCH) which occurs in the skeletal system and multiple organs. As it is progressive, sometimes it causes fatal results. However, it is often misdiagnosed as LCH or multiple bone metastasis and, thus, is very difficult to diagnose. In Korea, only 10 cases were first reported in 1999. In particular, there have been a few orthopedic approaches or reports in English-speaking literatures, and no report has been issued in Korea. The authors performed bone biopsy in patients with knee and lower extremity pain who were referred for the integrated treatment. We attempts to report this diagnosis experience with literature review.
Biopsy ; Erdheim-Chester Disease ; Histiocytosis ; Histiocytosis, Langerhans-Cell ; Humans ; Knee ; Korea ; Lower Extremity ; Neoplasm Metastasis ; Orthopedics

This study includes 19 cases of complicated low extremity injury to whom underwent microvascular free-tissue transfer in cases of open comminuted fracture, osteomyelitis, and vascular compromise or extensive soft tissue defect from Nov. 1994 to July 1997. The average time after injury to coverage was 25 days. The nineteen patients underwent a total of nineteen free tissue transfers primarily, and eighteen (94.7 per cent) of the transfers survived. Major complications were encountered recurrent failure of the free tissue transfer in one patient and partial necrosis in the other flap, which were successfully treated by flow-through radial forearm free flap and distally based superficial sural artery flap respectively. Two patients were sustained below knee amputation, one above knee amputation, despite of survival of flaps. This reveals limb salvage in 84 percent. The microvascular reconstruction is a versatile and reliable methods in complicated cases after severe trauma. Free tissue transplantation should be considered as a primary treatment in such complicated cases.
Amputation ; Arteries ; Extremities ; Forearm ; Fractures, Comminuted ; Free Tissue Flaps ; Humans ; Knee ; Limb Salvage ; Lower Extremity* ; Necrosis ; Osteomyelitis ; Tissue Transplantation ; Transplants

No abstract available.
Bone Cysts* ; Fractures, Spontaneous*

Basal cell carcinoma is the most common skin cancer, especially on the eyelid and nose. As it rarely invades to a underlying bone or metastasizes an distant site, and is usually found at an early stage, it is regarded as a curative disease. However, basal cell carcinoma on the eyelid and nose may be resected incompletely due to efforts to preserve important structures or as a result of esthetic considerations. We experienced two cases of basal cell carcinoma with local invasion to underlying bone. One was a recurred case on the nasal area extending to the nasal bone arts medial wall of the ethmoid sinus. The lesion was widely resected and covered with a radial forearm free flap. The other was on the eyelid extending to the orbit. It was treated with orbital exenteration and resection of the involved eyelid. The defect was reconstructed with the temporalis muscle flap with split-thickness skin graft. These patients were followed up for 7 months with no evidence of recurrence. Since basal cell carcinoma can invade to the bone and metastasize to a distance site, it should be resected radically in the regions of the eyelid and nose.
Carcinoma, Basal Cell* ; Ethmoid Sinus ; Eyelids ; Forearm ; Free Tissue Flaps ; Humans ; Nasal Bone ; Nose ; Orbit ; Recurrence ; Skin ; Skin Neoplasms ; Transplants

One hundred fifty bacteriae isolated in significant numbers from 96 specimens of urine of the 45 in-patients with long-term indwelling catheter were evaluated from January, 1978 to July. 1979 and the following results were obtained; 1. In 20 patients (44.4%), positive urine culture was obtained within 10 days after indwelled catheter in the urinary tract and 97.9% of the patients revealed the positive urine culture within 20 days after that. 2. Of 150 bacterial strains isolated by cultures of the urine, 96% was gram-negative bacteria and 4% was gram-positive. Isolated organisms included klebsiella(27.4%), E.coli(23.3%). proteus(14.7%), pseudomonas(12.0%). coliform bacilli(10.0%). other gram-negative organism (8.6%), staphylococcus(2.7%) and streptococcus (l.3%) in order of frequency. 3. In 4 patients(8.9%), bacteremia was developed. Isolated organism from blood culture and those from urine culture were same. The mortality rate was 50%.
Bacteremia ; Bacteria ; Catheters ; Catheters, Indwelling* ; Gram-Negative Bacteria ; Humans ; Mortality ; Streptococcus ; Urinary Tract Infections* ; Urinary Tract*

Renal angiography provides the ultimate in detailed vascularization of the renal vessels and vascular architecture of kidney. It is used in diagnosis and treatment of renal diseases e.g. renal injury, tumor, cyst and inflammation. A clinical observation of renal angiography was made on 49 cases of renal diseases which had been admitted to the Department of Urology, National Medical Center from 1975 to 1979. The diagnostic accuracy of renal angiography was 87.8%.
Angiography* ; Diagnosis ; Inflammation ; Kidney ; Urology

No abstract available.
Heart Valves* ; Heart*