BACKGROUND: The purpose of this study is to compare the radiological and clinical outcomes after open reduction and plate fixation of midshaft clavicle fractures between patients who achieved successful anatomical reduction and those who had a remaining fracture gap even after open reduction and plate fixation, and were thus treated with additional demineralized bone matrix (DBM). METHODS: This retrospective analysis was conducted on 56 consecutive patients who underwent open reduction and internal fixation using a locking compression plate for acute displaced midshaft clavicle fractures, and who underwent radiographic and clinical outcome evaluations at least 6 months postoperatively. The outcomes between those who achieved perfect anatomical reduction without remnant gap (n=32) and those who had a remaining fracture gap even after open reduction and plate fixation treated with additional DBM (n=24) were evaluated. RESULTS: There were no differences in the use of lag screws or wiring and operation time (all p>0.05) between those with and without remnant gap. No difference in the average radiological union time and clinical outcomes (satisfaction and Constant score) was observed between the two groups (all p>0.05). However, significantly faster union time was observed for AO type A fracture compared with other types (p=0.012), and traffic accident showed association with worse clinical outcomes compared with other causes of injury. CONCLUSIONS: Surgical outcome of midshaft clavicle fracture was more affected by initial fracture type and event, and re-reduction and re-fixation of the fracture to obtain a perfect anatomical reduction spending time appears to be unnecessary if rigid fixation is achieved.
Accidents, Traffic ; Bone Matrix ; Clavicle* ; Fracture Fixation ; Fracture Healing ; Humans ; Retrospective Studies

No abstract available.
Lymphoma, T-Cell* ; T-Lymphocytes*

Mycoplasma pneumoniae is the only known human pathogen among the Mycoplasma species isolated from the human respiratory tract. This pathogen causes respiratory infections most commonly in school-aged children and young adults. It may causes a variety of pulmonary manifestations and a few complication. empyema(pyothorax) as a complication of mycoplasma infection in children has been rarely reported. We report these two cases of empyema(pyothorax) preceded by Mycoplasma pneumoniae pneumonia in 5-year-old boy and 6-year-old girl. They were successfully managed by administration of antibiotics as well as surgical drainage.
Anti-Bacterial Agents ; Child* ; Child, Preschool ; Drainage ; Empyema ; Empyema, Pleural ; Female ; Humans ; Male ; Mycoplasma Infections ; Mycoplasma pneumoniae* ; Mycoplasma* ; Pneumonia* ; Pneumonia, Mycoplasma* ; Respiratory System ; Respiratory Tract Infections ; Young Adult

BACKGROUND: The purpose of this study is to compare the radiological and clinical outcomes after open reduction and plate fixation of midshaft clavicle fractures between patients who achieved successful anatomical reduction and those who had a remaining fracture gap even after open reduction and plate fixation, and were thus treated with additional demineralized bone matrix (DBM). METHODS: This retrospective analysis was conducted on 56 consecutive patients who underwent open reduction and internal fixation using a locking compression plate for acute displaced midshaft clavicle fractures, and who underwent radiographic and clinical outcome evaluations at least 6 months postoperatively. The outcomes between those who achieved perfect anatomical reduction without remnant gap (n=32) and those who had a remaining fracture gap even after open reduction and plate fixation treated with additional DBM (n=24) were evaluated. RESULTS: There were no differences in the use of lag screws or wiring and operation time (all p>0.05) between those with and without remnant gap. No difference in the average radiological union time and clinical outcomes (satisfaction and Constant score) was observed between the two groups (all p>0.05). However, significantly faster union time was observed for AO type A fracture compared with other types (p=0.012), and traffic accident showed association with worse clinical outcomes compared with other causes of injury. CONCLUSIONS: Surgical outcome of midshaft clavicle fracture was more affected by initial fracture type and event, and re-reduction and re-fixation of the fracture to obtain a perfect anatomical reduction spending time appears to be unnecessary if rigid fixation is achieved.
Accidents, Traffic ; Bone Matrix ; Clavicle ; Fracture Fixation ; Fracture Healing ; Humans ; Retrospective Studies

Wegener's granulomatosis (WG) is a systemic necrotizing vasculitis belonging to the small- to medium-sized vessel. A 46-year-old male presented with erythematous hard plaque on chest, calf and multiple subcutaneous nodules on buttock, upper arm. Incisional biopsy was done and the histopathologic finding revealed the features of necrotizing vasculitis with focal granulomatous inflammation in subcutaneous tissue. PNS MRI showed abnormal meningeal enhancement and lung HRCT imaging showed mild infiltration. Inspite of severe systemic involvement, serum tests about ANCA showed negative result. He was treated with systemic corticosteroid and cyclophosphamide pulse therapy. Initially his condition showed improvement but later the disease worsened.
Antibodies, Antineutrophil Cytoplasmic ; Arm ; Biopsy ; Buttocks ; Cyclophosphamide ; Glycosaminoglycans ; Humans ; Inflammation ; Lung ; Male ; Middle Aged ; Subcutaneous Tissue ; Thorax ; Vasculitis ; Wegener Granulomatosis

BACKGROUND: Nummular eczema, known as nummular dermatitis or discoid eczema, is an idiopathic disease that manifests coin-shaped, circular, or oval-shaped plaques with definite margins. These plaques can be exudative, erythematous, or edematous. The plaques are composed of tiny vesicles in the early stage, and later tend to be more scaly, dry, lichenified and thickened. It is a chronic condition which exhibits long periods of recurrence and relapse, plus changes depending on environmental conditions. For example, it is known that the eczema worsens in low humidity, or during winter. OBJECTIVE: Since there has been an absence of studies conducted since the 1970's, we investigated epidemiology, etiology, aggravation factors, family and past history, associated diseases such as atopic dermatitis, clinical menifestations, laboratory abnormalities, and course and prognosis with statistical analysis. METHOD: A total of 211 individuals, who had visited the Department of Dermatology, Kyungpook National University Hospital in Daegu, Korea between 2000-2004 with a diagnosis of nummular eczema, were selected. The data was based on a retrospective survey of hospital records. However, whenever the information was lacking, we called patients to ask lists of questions for this investigation. To clarify the prognosis and course of nummular dermatitis, we classified the course of the disease into 5 groups; "healed" (cleared completely), "almost healed" (more than 90% cleared), "improved" (from 50 to 90% cleared), "stationary" (less than 50% improvement), and "wax & waned" (repetitive recurrence). RESULTS: The male to female distribution showed about a 1.4-fold predominance for males. The onset of the disease in patients was often in their twenties, which correlated with previous reports which noted that onset of lesions in patients occurred in their twenties and sixties. Nummular eczema was most frequently aggravated in summer. Thirty five of the 211 patients had atopic dermatitis, and 53 had dry skin. Thirty five of 103 patients showed an elevated serum Ig E level (more than 250 IU/ml). Seventeen of 120 patients had an elevated eosiophil count (more than 7%). If the patients had had the eczema for a short duration, these seemed to be a better chance of the condition healing. CONCLUSION: This investigation is expected to help understand and obtain more information on nummular eczema.
Daegu ; Dermatitis ; Dermatitis, Atopic ; Dermatology ; Diagnosis ; Eczema* ; Epidemiology ; Female ; Gyeongsangbuk-do ; Hospital Records ; Humans ; Humidity ; Korea ; Male ; Prognosis ; Recurrence ; Retrospective Studies ; Skin

BACKGROUND: Hair loss including androgenetic alopecia and chronic telogen effluvium is recognized increasingly as a physically and psychologically harmful medical condition. Mesotherapy is considered as a new therapeutic modality for hair loss. OBJECTIVE: We studied to determine the effect of medications used in mesotherapy on hair organ culture and culture of dermal papilla cells. METHODS: First, occipital hair follicles were collected from patients with androgentic alopecia and separated into single hair follicles. The single hair follicles were cultured in William E media mixed with mesotherapy medications such as lidocaine, placental extract, Pondil(R), CRP-1000(R), and mixture of all these medications at different concentrations (1, 10, 50 microliter). On the 8th day, the cultured single hairs were stained with H&E and the length of those was measured under a microscope to compare with control group. Immunofluorescent study was performed to check expression of Ki-67, Bcl-2 and Bax on the hairs. Second, dermal papilla cells were isolated from occipital anagen hairs of patients with androgenetic alopecia and cultured in Dulbeco's modified Eagle's medium (DMEM). The mesotherapy medicines were added to the medium with one and two thousand dermal papilla cells, respectively. At the 3rd day, survival of the cells was evaluated with ELISA method comparing with control group. RESULTS: There were no statistical differences of the length of the hairs and the survival of the dermal papilla cells between experimental and control groups. With Bcl-2, we couldn't see any differences between experimental and control groups. With Ki-67, experimental groups showed less expression than control group. On the contrary, experimental groups showed more expression than control group in case of Bax. CONCLUSION: We can conclude from the results that the four medications used in mesotherapy are not effective for growth of cultured hair follicles and survival of cultured dermal papilla cells. However, more study would be needed for the establishment of objective and scientific evidences supporting mesotherapy and we should be in search for new medications for mesotherapy.
Alopecia ; Enzyme-Linked Immunosorbent Assay ; Hair Follicle ; Hair* ; Humans ; Lidocaine ; Mesotherapy* ; Organ Culture Techniques*

BACKGROUD: Drug resistant virus has been seen with all effective antiretroviral drugs in current practice. The isolation of resistant virus from subjects is associated with more rapid clinical outcome. The presence of resistance-conferring mutations in a patient in whom therapy is failing indicates that other antiretroviral drugs should be considered. So, the identification of drug resistant Human Immunodeficiency Virus (HIV-1) mutations is of increasing importance. Zidovudine monotherapy for HIV-1 infection has been widely used in Korea since 1990. So, the prevalence of zidovudine resistant virus has been expected to be high. The purpose of the present study is to determine the prevalence of zidovudine resistant HIV-1 among zidovudine-naive Korean patients. METHODS: We tested drug susceptibility of HIV-1 isolated from 19 zidovudine-naive Korean patients. We amplified a portion of gene reverse transcriptase of HIV-1 by RT nested PCR method. The susceptibility of HIV-1 to zidovudine was determined by sequencing the DNA base pairs of gene reverse transciptase. RESULTS: Two (10.5%) of 19 HIV-1 isolates from zidovudine naive patients showed resistance conferring mutations to zidovudine. Two (2.1%) of 95 codons analysed from zidovudine naive patients showed mutations conferring resistance to zidovudine. CONCLUSION: The prevalence of zidovudine resistant HIV-1 was 10.5% among zidovudine-naive Korean patients.
Base Pairing ; Codon ; DNA ; HIV* ; HIV-1* ; Humans* ; Korea ; Polymerase Chain Reaction ; Prevalence* ; RNA-Directed DNA Polymerase ; Zidovudine*

Pregnancy with scrub typhus is a rare condition. A 30-year-old woman was infected with scrub typhus at the 35th week of gestation. She was treated successfully with azithromycin, and delivered her baby uneventfully. The baby developed no signs for scrub typhus, and thrived well. IgM antibodies to O. tsutsugamushi were undetectable in the baby's sera, and titers of IgG antibodies did not rise. The polymerase chain reaction of the cord blood for O. tsutsugamushi was also negative. We concluded that transplacental infection did not occur in this pregnant woman.
Adult ; Antibodies ; Azithromycin ; Female ; Fetal Blood ; Humans ; Immunoglobulin G ; Immunoglobulin M ; Polymerase Chain Reaction ; Pregnancy ; Pregnant Women* ; Scrub Typhus*

Pseudomonas aeruginosa pneumonia is characteristically found as a hospital-acquired infection in patients with underlying medical disorders. Few cases of community acquired P. aeruginosa pneumonia have been reported in individuals without underlying diseases. We report a case of P. aeruginosa pneumonia in a healthy 33-year-old man. He visited our hospital because of fever, non-productive cough, and pleuritic chest pain. On physical examination, the breathing sounds were decreased on the right lower lung field. The chest radiograph showed lobar consolidations with a cavity on the right upper lung field. Blood cultures and a pleural fluid culture yielded P. aeruginosa. Despite aggressive management including antibiotics and mechanical ventilation, he died 26 hours after the onset of symptoms. P. aeruginosa should be included in the differential diagnosis of severe community-acquired pneumonia.
Adult* ; Anti-Bacterial Agents ; Chest Pain ; Cough ; Diagnosis, Differential ; Fever ; Humans ; Lung ; Physical Examination ; Pneumonia* ; Pseudomonas aeruginosa* ; Pseudomonas* ; Radiography, Thoracic ; Respiration, Artificial ; Respiratory Sounds ; Sepsis