Acute bacterial infection of bone and joint presents a real challenge to orthopedist because early diagnosis and treatment are difficult and also essential. In almost all practices, fever and erythrocyte sedimentation rate(ESR) are widely used for monitoring the course, for estimating the effectiveness of treatment, and for the recovery of such illnesses. However, interpreting body temperature is difficult and ESR is nonspecific, is not not sensitive, normalizes slowly. Otherwise, C-reactive protein(CRP) is very sensitive and normalizes fast. CRP, body temperature, and ESR were sequentially measured until a normal value was reached in twenty seven patients in whom acute osteomyelitis (17 patients), acute exacerbation of chronic osteomyelitis(4 patients), and septic arthritis(6 patients) had been diagnosed by positive bacterial culture at Kyungpook National University Hospital from June 1984 to May 1985. The results were as follows: 1. CRP normalized within 8.8 days on average. 2. Fever lasted 4.5 days on average. 3. ESR normalized within 41.6 days on average. 4. Initial mean value of CRP was 4.2 positive in acute in acute osteomyelitis and septic arthritis and 3.5 positive in acute exacerbation of chronic osteomyelitis, therefore CRP can be considered as a very sensitive indicator for early detection of acute bacterial infection of bone and joint. Also sequential CRP determination can be used for monitoring the course, for estimating the effectiveness of treatment, and for the recovery of such illnesses.
Arthritis, Infectious ; Bacterial Infections ; Blood Sedimentation ; Body Temperature ; C-Reactive Protein ; Early Diagnosis ; Fever ; Gyeongsangbuk-do ; Humans ; Joints ; Osteomyelitis ; Reference Values

PURPOSE: To evaluate the efficacy of combined treatment of metallic biliary stent placement and radiotherapy in malignant biliary obstruction. MATERIALS AND METHODS: Between January 1992 and February 1994, 22 patients with malignant biliary obstruction were treated with metallic biliary stent placement and radiotherapy. The causes of the obstruction included cholangiocarcinoma(n=14), gallbladder carcinoma(n=4), colon cancer(n=2), pancreatic head cancer (n=1), and stomach cancer(n=1). According to the sites of obstruction level, patient were divided into 2 groups; hilar obstruction(n=18) and common bile duct obstruction(n=4). The patients received dose of 45 Gray/18 fraction by external radiotherapy and 20Gy/8f by high dose rate brachytherapy with iridium--192 source through percutaneous transhepatic biliary drainage(PTBD) catheter. The duration of stent patency after placement, survival period and survival rate by Kaplan Meier method were calculated in dead and alive patients, respectively. RESULTS: In all 22 patients, the duration of stent patency was 5.5(1.3--18.5)months. Survival periods after stent placement and PTBD were 5.3(2.0--8.5 )months and 7.9(4.0--14.7)months respectively in 9 dead patients and 7.7(1.3--21.0)months and 9.5(2.3--23.0)months in 13 alive patients. In all 22 patients, the survival rates in 6, 12 and 18 months were 78.9%, 47.5 % and 35.6 %, respectively. CONCLUSIONS: The results with combined metallic biliary stent placement and radiotherapy for the palliative treatment of malignant biliary obstruction in this study was more favorable, as compared with those of the other authors with only metallic biliary stent placement.
Brachytherapy ; Catheters ; Colon ; Common Bile Duct ; Gallbladder ; Head and Neck Neoplasms ; Humans ; Palliative Care ; Radiotherapy* ; Stents* ; Stomach ; Survival Rate

PURPOSE: To evaluate the usefullness of repeated alcohol sclerotherapy for two days through the percutaneous catheter in the treatment of renal cyst. MATERIALS AND METHODS: Repeated sclerotherapies using absolute ethanol(99.9%) were parformed on 20 renal cysts in 18 patients through the indwelling catheter. The cyst volume ranged from 50 ml to 1000ml(mean, 300ml). Under the ultrasound- or CT-guidance, 6F catheter was inserted into the cyst percutaneously. After aspirating the fluid in the cyst, absolute ethanol was injected. While maintaining the catheter for 16-20 hours, at least 3 times of sclerotherapies performed with total procedure time of 30-60 minutes. Follow-up sonography was performed to evaluate the recurrence or collapse of the cysts at 1 and 3 months after the procedure. RESULTS: Among 20 renal cysts, 2 cases were recurred on 1 month follow-up sonography(10%). However, the volumes of recurred cysts were decreased to 40% and 10%, respectively. There was no immediate or delayed complication after sclerotherapy. DISCUSSION: Repeated sclerotherapy for 2 days using absolute ethanol through the percutaneous catheter insertion is a useful method of treatment for renal cyst.
Catheters* ; Catheters, Indwelling ; Ethanol ; Follow-Up Studies ; Humans ; Recurrence ; Sclerotherapy*

No abstract available.
Rupture* ; Subclavian Artery*

No abstract available.
Anniversaries and Special Events* ; Female ; Humans

The management of chronic osteomelitis of the tibial diaphysis and certain post-traumatic defects of the lower extremity is extremely difficult. the diverse methods of treatment signify current dissatisfaction with any single method. Recently, the muscle transposition technique has gained an accepted place in treating wide soft tissue defect with bone exposure. Popularized by Ger, Vasconez, Pers, Mc Hugh and others, this technique is generally simple, safe, and reliable, The 21 patients who treated by muscle transposition at the Kyungpook National University Hospital between 1980 and 1987 were reported. The results were as follows :l. 19 patients were males and 2 were females. 2. The cause of lesion were 8 cases of open fracture, 10 cases of chronic osteomyelitis, chronic ulcer 1 case, malignent melanoma 1 case, burn scar contracture 1 case. 3. The muscles used for transposition according to lesion site of leg were as follows. Medial head of gastrocnemius was transposed in 2 case of knee and 4 cases of proximal 1/3 lesion, 11 cases of middle l/3 lesion was used soleus, 1 cases were gastrocnemius after soleus, 1 case was tibialis anterior, 2 cases of distal 1/3 were used each 1 case of solus, 1 case of F.H.L. 4. All cases were healed within 2 to 3 weeks after muscle transposition, and this technique seemd to afford favorable influence upon the healing of fracture and the eradication of infection.
Burns ; Cicatrix ; Contracture ; Diaphyses ; Female ; Fractures, Open ; Gyeongsangbuk-do ; Head ; Humans ; Knee ; Leg ; Lower Extremity ; Male ; Melanoma ; Methods ; Muscles ; Osteomyelitis ; Ulcer

In 1814, Monteggia first described a fracture of proximal third of the ulna with a dislocstion of radial head. Bado named Monteggia lesion as a fraeture of ulnar at any level and a dislocaion of radial head and classified fracture as 4 types. The authors reviewed thirty-two patients of Monteggia fracture who were trested at department of orthopedic surgery, Kyung Pook University college of medicine from 1977. 1 to 1986. 12. Using new criteria of Bruce et al we evaluated results for 20 paients who follow up was possible. The results obtained were as follows ; 1. Tota 32 patients were 10 children and 22 aults. Male is 4 times more than female. 2. The cause of injury was fall down 12, trsffic accident 17 and machinsry injury 3 pati ents. 3. According to Bado clsssification, type I was 56%, type II 16%, type III 22% and type V 6%. 4. Direction of radial head dislocation was as follows ; Anterior was 16, anterolateral 10, posterior 3 posterolateral 1 latersl 2. 5. Location of ulna fracture site was as follows ; Metaphysis was 6, proximal 1/3 20, mid shaft 5, distal 1/3 1. 6. Treatments of dislocated radial head were closed reduction in 31 patients open reduction in 1 patient. 7. Treatment of fractured ulna was different between children and adult. 9 patients among ten children patient were managed by closed reduction, only 1 case by open reduction but all 22 adults were managed by open reduction and internal fixation. 8. Palsy of posterior interosseous nerve was observed in 6 and recovered completely within 8 months. 9. The results(Bruce et al) for 20 cases followed 5 months more were excellent 4 good 7 fair 5 poor 4. In children, prognosis and recovery was good and shorter.
Adult ; Child ; Clinical Study ; Dislocations ; Female ; Follow-Up Studies ; Head ; Humans ; Male ; Monteggia's Fracture ; Orthopedics ; Paralysis ; Prognosis ; Ulna ; Ulna Fractures

Isolated fetal ascites may be different from general category of nonimmune hydrops in both prenatal course and prognosis. We experienced one case of isolated fetal ascites of unknown origin treated by in utero ultrasound-directed paracentesis and so present it with brief review of literature.
Ascites* ; Edema ; Paracentesis* ; Prognosis

This is an autopsy-verifed case of the generalized cytomegalic inclusion disease occuring in a male fetus of a weeks gestation. The fetus revealed hydrocephalus and focal necrosis of brain, focal subcapsular necrosis of liver, and the typical cytomegalic inclusion cells having large acidophilic intranuclear inclusions in the liver, brain, kidney, lung, adrenal gland, pancreas and chorionic villi. Prominent extramedullary hematopoiesis was noted in the liver and kidney. Immuohistochemical staining using anti-cytomegalovirus antibody revealed intranuclear or occasionally intracytoplasmic immunoreactivity in brain, liver, pancreas, lung, kidney, and intestine.
Male ; Humans

This is an autopsy-verifed case of the generalized cytomegalic inclusion disease occuring in a male fetus of a weeks gestation. The fetus revealed hydrocephalus and focal necrosis of brain, focal subcapsular necrosis of liver, and the typical cytomegalic inclusion cells having large acidophilic intranuclear inclusions in the liver, brain, kidney, lung, adrenal gland, pancreas and chorionic villi. Prominent extramedullary hematopoiesis was noted in the liver and kidney. Immuohistochemical staining using anti-cytomegalovirus antibody revealed intranuclear or occasionally intracytoplasmic immunoreactivity in brain, liver, pancreas, lung, kidney, and intestine.
Male ; Humans