Slipped femoral capital epiphysis is a rare entity in Korea and only three cases have been reported so far1,2,3). One of our cases was a unilateral mild chronic slip in a 14 year old boy with Frohlich body type. It was treated by gentle closed reduction followed by knowles' pin fixation. The other case, a 20 year old female, presented chondrolysis of the left hip. Scrutinization of roentgenograms revealed typical features of an unrecognized slipped femoral capital epiphysis. It was treated by Wagner resurfacing replacement arthroplasty.
Arthroplasty, Replacement ; Epiphyses ; Female ; Hip ; Humans ; Korea ; Male ; Somatotypes

BACKGROUND: External ventricular drainage (EVD) is an important procedure for draining excessive cerebrospinal fluid (CSF) and monitoring intracranial pressure. Generally, EVD is performed in the operating room (OR) under aseptic conditions. However, in emergency circumstances, the operation may be performed in the intensive care unit (ICU) to save neuro-critical time and to avoid the unnecessary transfer of patients. In this study, we retrospectively analyzed the risk of EVD-induced CNS infections and their outcomes according to the operating place (ICU versus OR). In addition, we compared mortalities as well as hospital and ICU days between the CNS infection and non-CNS infection groups. METHODS: We reviewed medical records, laboratory data and radiographic images of patients who had received EVD operations between January, 2013 and March, 2015. RESULTS: A total of 75 patients (45 men and 30 women, mean age: 58.7 +/- 15.6 years) were enrolled in this study. An average of 1.4 catheters were used for each patient and the mean period of the indwelling catheter was 7.5 +/- 5.0 days. Twenty-six patients were included in the ICU group, and EVD-induced CNS infection had occurred in 3 (11.5%) patients. For the OR group, forty-nine patients were included and EVD-induced CNS infection had occurred in 7 (14.3%) patients. The EVD-induced CNS infection of the ICU group did not increase above that of the OR group. The ICU days and mortality rate were higher in the CNS infection group compared to the non-CNS infection group. The period of the indwelling EVD catheter and the number of inserted EVD catheters were both higher in the CNS infection group. CONCLUSIONS: If the aseptic protocols and barrier precautions are strictly kept, EVD in the ICU does not have a higher risk of CNS infections compared to the OR. In addition, EVD in the ICU can decrease the hospital and ICU days by saving neuro-critical time and avoiding the unnecessary transfer of patients. Therefore, when neurosurgeons decide upon the operating place for EVD, they should consider the benefits of ICU operation and be cautious of EVD-induced CNS infection.
Catheter-Related Infections ; Catheters ; Catheters, Indwelling ; Cerebrospinal Fluid ; Drainage* ; Emergencies ; Female ; Humans ; Intensive Care Units* ; Critical Care* ; Intracranial Pressure ; Male ; Medical Records ; Mortality ; Operating Rooms* ; Retrospective Studies ; Ventriculostomy

We report a case of metastatic carcinoma of the skin in 62-year-old male who showed multiple nodules on the anterior chest, scalp, face and left axilla for 2 months duration. He suffered from lower abdominal discomfortness for 6 months. Histopathologic findings revealed atypical cell nests and some tubular or glandular formation in the dermis and subcutaneous fat tissue. Material in the lumen showed diastase resistant and PAS positive, and alcian blue positive at pH 2.4, but negative pH 0.4. So it represented sialomucin. We did not find primary site of malignant tumor. In view of clinical and histopathological findings, it was considered to be originated from the large intestine.
Alcian Blue ; Amylases ; Axilla ; Dermis ; Humans ; Hydrogen-Ion Concentration ; Intestine, Large ; Male ; Middle Aged ; Scalp ; Sialomucins ; Skin* ; Subcutaneous Fat ; Thorax

BACKGROUND: Quality control is important for accurate diagnosis of human immunodeficiency virus (HIV) infection, and proficiency testing with external quality controls is an important part of quality control. This study intended to develop and supply customized external quality controls for HIV antigen/antibody testing fitted with currently used reagents for standardization of HIV infection diagnosis and evaluation of HIV testing competency of laboratories in Korea. METHODS: Serological tests and inactivation were performed on the obtained HIV antibody positive plasma. To manufacture quality controls having the required antibody titers, dilution ratio was searched using VIDAS (bioMérieux, France), Architect (Abbott Laboratories, USA), and Cobas 8000 (Roche Diagnostics, Germany) analyzers. Diluted source plasma was divided into aliquots after filtering. Homogeneity and stability of the produced external quality controls were evaluated. RESULTS: The collected HIV antibody positive plasma was confirmed by Western blot. Dilution ratios for source plasma were produced for each analyzer showing signal-to-cut-off 2–3, 5–7, and 15–16 reactivity. Diluted plasma was made to 1 mL aliquots and total set of 1,500 external quality controls for HIV antigen/antibody were manufactured. Produced controls satisfied the required criteria of homogeneity and showed less than 10% coefficient of variation for stability except negative controls. CONCLUSIONS: Customized external quality controls were developed and qualified for HIV testing reagents used in Korea. Continuous external quality control assessment for HIV tests with controls would be required.
Blotting, Western ; Diagnosis ; HIV Infections ; HIV* ; Humans* ; Indicators and Reagents ; Korea* ; Plasma ; Quality Control* ; Serologic Tests

We measured plasma B-Endorphin in 10 patients with cerebral thrombosis, with comparing normal control group and obtained the following results. 1. The mean value of plasma B-Endorphin was 6.173+0.335 pmol/l in normal control male group and 4.55+0.443 pmol/l in normal control female group. 2. The level of plasma B-Endorphin was increased as mean value was 29.2 pmol/o in acute phase of cerebral thrombosis and it showed significant statistical difference. 3. Measurement on convalescent phase in patient with cerebral thrombosis also increased significantly compared with normal control group, but reduced significantly compared with patients in acute phase.
Female ; Humans ; Intracranial Thrombosis* ; Male ; Plasma*

Malposition of the extracorporeal membrane oxygenation (ECMO) venous cannula in the azygos vein is not frequently reported. We hereby present such a case, which occurred in a neonate with right-sided congenital diaphragmatic hernia. Despite ECMO application, neither adequate flow nor sufficient oxygenation was achieved. On the cross-table lateral chest radiograph, the cannula tip was identified posterior to the heart silhouette, which implied malposition of the cannula in the azygos vein. After repositioning the cannula, the target flow and oxygenation were successfully achieved. When sufficient venous flow is not achieved, as in our case, clinicians should be alerted so they can identify the cannula tip location on lateral chest radiograph and confirm whether malposition in the azygos vein is the cause of the ineffective ECMO.
Azygos Vein* ; Catheters* ; Extracorporeal Membrane Oxygenation* ; Heart ; Hernias, Diaphragmatic, Congenital* ; Humans ; Infant, Newborn* ; Oxygen ; Radiography, Thoracic

PURPOSE: Perinatal asphyxia occurring in newborn is one of the major causes of acute mortality and chronic neurological disability in survivors. We have studied the relationship between early electroencephalography(EEG) findings and clinical course and neurologic outcome in severe asphyxiated neonates. METHODS: Between the period of July 1999 and June 2002, 25 neonates who were diagnosed with severe perinatal asphyxia(1-minute Apgar score of < or =3 and initial pH is less than 7.2) at NICU in Dongsan Medical Center were enrolled. An EEG was recorded and analyzed within three days of life and divided into two groups - group 1(normal or focal change on EEG) and group 2(generalized abnormal EEG). Between the two groups, clinical courses and neurologic outcomes were compared. RESULTS: Fifteen infants(60%) were group 1 and ten infants(40%) were group 2(polyspikes, burst- suppression, generalized low voltage). Associated maternal disease, days of hospitalization, need for ventilator support, delay of oral feeding and convulsion duration are significantly higher and longer in group 2. Also, poor neurologic outcome(expire, developmental delay) was significantly higher in group 2(60%) than group 1(13.3%). CONCLUSION: Thus, the early neonatal EEG in asphyxiated newborn can be a predictable diagnostic tool in assessment of neurologic outcome.
Apgar Score ; Asphyxia ; Electroencephalography ; Hospitalization ; Humans ; Hydrogen-Ion Concentration ; Infant, Newborn* ; Mortality ; Seizures ; Survivors ; Ventilators, Mechanical

We report herein a human sparganosis that presented confusing features in aspect of its correct identification, The patient was 35-year-old man who had a past history of eating fried frogs since 3 years prior to his first admission in 198I. Three mature Sparganum mansoni and 69 encapsulated spargana pieces were excised from his left inguinal area, left thigh and scrotum by three consecutive operations in 19 months. The encapsulated spargana were irregular in shape and size and mummified. They were identified histopathologically as degenerated spargana by no sexual organs and many calcareous bodies in the parenchyma. Differentiation of our case from proliferating sparganosis caused by Spargarrum proliferum was discussed.
Adult ; Eating ; Humans ; Scrotum ; Sparganosis* ; Sparganum ; Thigh

The purpose of this study was to evaluate the influence of high dose carbon tetrachloride (CCI4) on the hepatotoxic effect of dimethylnitrosamine (DMN) which induces acute hemorrhagic necrosis in liver. Rats were injected intraperitoneally DMN dissolved in physiologic saline by a dose of 40 mg/kg. For changes related to CCI⁴ pretreatment, rats were injected intraperitoneally CCI⁴ dissolved in olive oil by a dose of 0.4 mg/kg, and then injected DMN. The livers were extracted from the rats 3, 6, 12, 24, 48, 72, and 120 hours after CCI⁴ and/ or DMN injection. Liver tissues were examined with light and electron microscopes. The results were summarized as follows; Light microscopic findings: Severe centrilobular hemorrhagic necrosis developed from 12 hours after injection of DMN and continued to 120 hours. On injection of DMN after CCI4 pretreatment, Massive necrosis occurred early. But active regenerative changes were produced in 24 hours. In 120 hours, the liver recovered in almost normal appearance. The degree of necrosis in pretreated group was similar to that in DMN injection only, and the time of recovery was faster in pretreated group. Electron microscopic findings: The early change was mainly disorganization of RER in DMN injection, and clumping and vesicular dilatation of ER in injection of CCI4. In pretreatment group, the early change was similar in appearance with CCI4 group, but severer in degree. According to the results, it was revealed that acute toxic effect of DMN was recovered more rapidly in pretreatment group. Thus it was suggested that CCI4 had protective effect in DMN hepatotoxicity.
Animals ; Carbon Tetrachloride* ; Carbon* ; Dilatation ; Dimethylnitrosamine ; Hepatocytes* ; Liver ; Necrosis ; Olive Oil ; Rats

Bladder neck suspension to replace the bladder neck and proximal urethra into a high fixed retropubic position is paramount in the surgical treatment of genuine stress incontinence. Thirteen patients with grade II stress incontinence and one patient with grade III one underwent the Raz bladder neck suspension. All patients had no previous anti-incontinence operation. radiation therapy and pelvic trauma. Thirteen patients(93%) were cured and one patient(7%) improved with mean Follow-up period of 26 months. One failure case was due to insufficient suspension toward high retropubic position. The complications were not significant except temporary urinary retention of 2 to 9 days. The Raz bladder neck suspension providing good mobilization of paraurethral tissues is considerable way to the treatment of all types of genuine stress incontinence except those secondary to urethral intrinsic damage.
Follow-Up Studies ; Humans ; Neck ; Urethra ; Urinary Bladder ; Urinary Incontinence* ; Urinary Retention