Bacterial meningitis results in significant neurologic dificits despite in spite of much effort in the treatment of the disease. This study was performed to determine the incidence of caustive organisms and to correlate between the organisms and computed tomographic (CT) findings with clinical outcome of bacterial meningitis in newborns and infants. We analyzed the brain CT and clinical records of 15 infants who had been diagnosed as bactrial meningitis by CSF culture. We found that the most common organisms were Group B streptococcus in neonates withou no neurologic complications in all but one and Hemophilus influenza in infants whose clinical outomes were poor in all except one. CT findings related with poor prognosis in this study were cerebral edema, basal cistermal obliteration & enhancement, and cerebral infarction on initial CT and ventriculomegaly on follow-up CT. We concluded that CT diagnosed intracranial complications of bacterial meningitis well and could contributed to better treatment of bacterial meningitis.
Brain ; Brain Edema ; Cerebral Infarction ; Follow-Up Studies ; Haemophilus ; Humans ; Incidence ; Infant* ; Infant, Newborn* ; Influenza, Human ; Meningitis ; Meningitis, Bacterial* ; Prognosis ; Streptococcus

BACKGROUND AND OBJECTIVES: Dimenhydrinate is known to act on the vestibular system, causing vestiular suppression. But the effects related with therapeutic dosage on eye tracking tests and vestibulo-ocular reflex (VOR) are not clear yet. We performed this study to evaluate the effects of dimenhyrinate on eye tracking tests and VOR. MATERIALS AND METHODS: Twenty five healthy subjects, comprising of 12 men and 13 women between the ages of 15 and 69 (mean age=39) participated in this study. The assessment included saccade test, smooth pursuit test, optokinetic nystagmus test for eye tracking test and sinusoidal harmonic acceleration test for VOR test. Each test was performed before, and 2 hours and 4 hours after the oral intake of dimenhydrinate (therapeutic dosage: 50 mg). The subjects were kept alert by performing a calculation task and communicating with the investigator during tests. RESULTS: Analysis of results showed that latency was prolonged after 2 hours but was returned to initiae value after 4 hours. Gain was not changed in the saccade test as well as in the smooth pursuit test. Mean slow phase eye velocity (SPEV) decreased after 4 hours in optokinetic nystagmus test. Gain and phase lead decreased only at 0.01 Hz in sinusoidal harmonic acceleration test. CONCLUSION: Dimenhydrinate had minimal effects on eye tracking tests and VOR when the patient's alertness was kept during test.
Acceleration ; Dimenhydrinate* ; Female ; Humans ; Male ; Nystagmus, Optokinetic ; Pursuit, Smooth ; Reflex, Vestibulo-Ocular ; Research Personnel ; Saccades

No abstract available.
Eustachian Tube*

No abstract available.
Parathyroid Neoplasms* ; Radionuclide Imaging* ; Thymoma*

The synovial membrane of the temporomandibular joint lines all the intraarticular structures except the articular cartilage of the articular eminence, fossa, the mandibular condyle and the articular disc. The synovial membrane consists of two layers. The first layer is a lining cell layer facing the joint space and called synovial intima. The second layer is called subintimal or subsynovial tissue. The synovial membrane fulfills several important functions in maintaining normal joint physiology and joint function. Synovitis occurs when the level of cellular debris and the concentration of chemical mediators of inflammation produce levels that the synovial membrane is unable to ingest, absorb or process. So degeneration of temporomandibular joint may be increased by deficiency of synovial fluid. After general anesthesia by intramuscular injection of ketamin, exposure of TMJ of rabbit was done by preauricular approach. After exposure, rubber drain was inserted into the upper joint cavity, to prevent accumulation of synovial fluid. Penicillin G was used to prevent secondary infection for 3 days. Fifteen Rabbits were used for experiment, and subdivided into 5 groups (one normal group and 4 experimental groups, each subdivided group consisted in 3 rabbits). Experimental groups were taken after period of 1, 2, 3, 4 weeks. After euthansia, enbloc excision of TMJ was done to make biopsy specimen. The results were as follows; 1. Layers of synovial intima were increased in experimental group, 8~10 layers in first week group and 4~5 layers in fourth week group as compared with 2~3 layers in normal group. 2. Inflammation, vascular change and subintimal edema were highest in second week group, but continued to fourth week group. 3. Subintimal fibrosis occured in second week group, and increased to fourth week group. 4. Due to fibrosis of joint cavity, narrowing of joint space occured in the third week group, and increased to fourth week group. 5. Degeneration of articular disc occured in second week group and increased to fourth week group.
Anesthesia, General ; Biopsy ; Cartilage, Articular ; Coinfection ; Edema ; Fibrosis ; Inflammation ; Inflammation Mediators ; Injections, Intramuscular ; Joints* ; Mandibular Condyle ; Penicillin G ; Physiology ; Rabbits* ; Rubber ; Synovial Fluid* ; Synovial Membrane ; Synovitis ; Temporomandibular Joint

No abstract available.
Electric Stimulation* ; Vocal Cords*

No abstract available.
Incus* ; Malleus*

The treatment and results of 6 cases of the femoral shaft fracture in children are prensented and the method of Charnleys traction unit used most frequently at Korea General Hospital is described. Many Kinds of traction for the femoral shaft fracture in children was introduced. But nearly all methods which depend on heavy traction are open to the following criticism; 1) It is impossible to diminish the traction force alone without jeopardising the stablity of the reduction. 2) Gravity is not used to help in correcting the deformity of backward angulation. 3) Backward angulation of the distal fragment can never be corrected by traction in the axis of the femur. To do this the direction of the traction must be delfected away from the axis of the femur. Charnleys traction offers the following features: 1 The foot is supported at right angles to the tibia. 2. The external popliteal nerve and calf muscles are protected from pressure against the slings of the splint. The tibia is suspendcd from the Steinmann pin inside the plaster so that an air space develops under the tibia as the calf muscles lose their bulk. 3. External rotation of the foot and distal fragment of the femur is controlled. 4. The tendo Achillis is protected from pressure sores. 5. Comfort; the patient is unaware of the traction when applied through the medium of the nail. Age distribution of the patients was from 2 years to 13 years. Initial angulation after the manual reduction was from 0 to 25 degree posteriorly and from 5 to 9 degree laterally. Angulation after radiological union was from 0 to 15 degree posteriorly and from 0 to 8 degree laterally. Overriding before reduction was from 0.9 to 3.2cm and after reduction from 0.3 to 1.2cm. The duration of the inmobilization in Charnleys traction unit was from 15 days to 57 days. The duration of radiological union was from 51 days to 94 days.
Age Distribution ; Child ; Congenital Abnormalities ; Femur ; Foot ; Gravitation ; Hospitals, General ; Humans ; Korea ; Methods ; Muscles ; Pressure Ulcer ; Splints ; Tibia ; Traction

PURPOSE:It is important to evaluate the healing process of avascular necrosis (AVN) involving femoral head after treatment. The purpose of this study was to assess the usefulness of pinhole bone scintigraphy in the AVN of femoral head after surgery. MATERIALS AND METHODS: We analyzed the changing pattern of pinhole bone scintigram in 21 femoral heads of 16 patients (14 lesions/11 male, 7 lesions/5 female, mean age: 39.4 yrs) before and after multiple drilling or vascularized bone grafting for AVN of the femoral head. In all patients, pre-operative scintigrams were obtained at 1 to 3 months before treatment and the first post-operative scintigrams were obtained at 1 to 3 months after treatment. All patients were followed for 2 to 4 years after operation. RESULTS: The findings of the pinhole scintigrams were divided into three patterns: 1) curvilinear, 2) scattered spotty and 3) undetermined. The 10 of 11 lesions with curvilinear pattern had good postoperative clinical and radiological follow-up findings. However, all 6 lesions with scattered spotty pattern showed poor postoperative findings, which necessitated total hip joint replacement. Of the 4 lesions with undetermined pattern, 2 required total hip joint replacement. There was significant difference in postoperative prognosis between the curvilinear and scattered spotty patterns (p<0.05). CONCLUSION: We conclude that the pattern of pinhole bone scintigram obtained within 1 to 3 months after multiple drilling or vascularized bone graft operation is a useful prognostic indicator in the AVN of femoral head.
Bone Transplantation ; Female ; Follow-Up Studies ; Head* ; Hip Joint ; Humans ; Male ; Necrosis* ; Prognosis* ; Radionuclide Imaging* ; Technetium Tc 99m Medronate ; Transplants*

No abstract available.
Gamma Cameras* ; Head*