After developement of antimicrobial chemotherapy, morbidity and mortality from pyogenic arthritis has been reduced dramatically, but still this disease has remained as a serious and lifethreatening infectious disease of childhood or late sequelae in surviving patients. For the period of 7 years from January 1973 to December 1979, fifty nine children who were treated as septic arthritis at Severance Hospital were studied retrospectively and the results are summerized as follows. 1. Among the 59 cases, 32 cases (54.25%) were male and 27 cases (45.8%) were female. The most prevalent age was 4 to 10 years (40%). 2. Lag period to treatment in most cases was 5 days, and the most prevalent signs on admission was pain around the involved joint. 3. The most commonly affected joint was the hip joint (42.4%). The other affected sites in order of frequency were the knee, ankle and shoulder joint. 4. The underlying causes were composed of infectious focus in 18 cases, minor trauma in 6 cases, iatrogenic reason in 4 cases and unknown in 31 cases. 5. In laboratory findings, the numbers of W.B.C. and E.S.R. were increased in 66.1%, and roentgenologic studies revealed normal in 67.7%, soft tissue swelling in 21% and joint space widening in 9.7%. 6. Causative micro-organism was isolated in 41 cases: Staphylococcus aureus in 34 cases. B-hemolytic streptococcus in 3, Pseudomonas aeroginosa in 2, Enterobacter species in 2. 7. Staphylococcus aureus was highly sensitive to Cephalothin (88.2%) and Methycillin (85.3%), but was highly resistant to Penicillin (88.2%). 8, Four cases were treated non-surgically and 55 cases surgically with arthrotomy-drainage and arthrotomy-continuous irrigation. The results were satisfactory in 83% and unsatisfactory in 17%. 9. The complications were found in 14 cases: recurrence in 4, joint stiffness in 3, dislocation in 2 and sepsis in 1 case. In conclusion, a better result was obtained in cases with early diagnosis and surgical treatment with proper antibiotics.
Ankle ; Anti-Bacterial Agents ; Arthritis ; Arthritis, Infectious ; Cephalothin ; Child ; Clinical Study ; Communicable Diseases ; Dislocations ; Drug Therapy ; Early Diagnosis ; Enterobacter ; Female ; Hip Joint ; Humans ; Joints ; Knee ; Male ; Mortality ; Penicillins ; Pseudomonas ; Recurrence ; Retrospective Studies ; Sepsis ; Shoulder Joint ; Staphylococcus aureus ; Streptococcus

No abstract available.
Metatarsal Bones* ; Osteogenesis, Distraction*

62 cases of the fracture of the pelvis admitted to the orthpedic department of Wonju Christian Hospital during past 5 years from 1975 to 1979 were reviewed and clinical results were obtained as follows: 1. Males were frequent than females and almost 3rd to 4th decades of life. 2. The causes of injury were traffic accident, coal minor accident, and falling. 3. Stable type is the most common in this series and among the unstable types, lateral compression type is the most common and then straddle type and vertical shear type. 4. The most common complication is uro-genital injury. 5. The residual complications at the end of treatment remained in some cases, Arthritis of sacroiliac joint, Impotence, Urethral stricture, Low back pain, etc. 6. All of the cases were treated conservatively and their results were somewhat good except 4 cases. 7. Surgical treatment would be considered, if necessory, to decrease the complications and reduce hospital days.
Accidental Falls ; Accidents, Traffic ; Arthritis ; Coal ; Erectile Dysfunction ; Female ; Gangwon-do ; Humans ; Low Back Pain ; Male ; Pelvic Bones ; Pelvis ; Sacroiliac Joint ; Urethral Stricture

No abstract available.
Fractures, Compression* ; Vertebroplasty*

Section of the corpus callosum(SCC) is a useful surgical therapy in selected types of epilepsy, i.e., tonic, atonic, and intractable generalized convulsive seizures. The object of this study was to determine effect of SCC on behaviors, electroencephalography(EEG) and Fos expression in the lithium-pilocarpine model of status epilepticus in the rat. A total of 40 Sprague-Dawley rats were used. They were divided into two groups: control and lesioned group, 20 rats for each. The control group had no callosal section and was injected with lithium-pilocarpine. The lesioned group had callosal section before lithium-pilocarpine injection. In each group, ten rats were used for behavior and EEG monitoring and other 10 were used for Fos expression. The results were as follows: 1) In the SCC group, four(40%) rats never developed status epilepticus, among them two(20%) never exhibited any seizure, while all of the control group developed seizure and status epilepticus. None of the SCC animals died until 24 hours after lithium-pilocarpine injection but 70% of the control animals died within 24 hours of status epilepticus. This difference was statistically significant(p<0.05). 2) The mean latency to the first seizure, status epilepticus and periodic epileptiform discharges after lithium-pilocarpine injection were 34.7+/-2.6min, 32.3+/-1.8min and 180.4+/-9.8min, respectively, in the SCC group, while was 21.0+/-2.0min, 58.2+/-6.9min and 215.6+/-7.2min, respectively, in the control group. These latencies were significantly longer than in the control group(p<0.05). 3) There was a massive Fos expression on the cerebral cortex in the control group at 4 hours after lithiumpi-locarpine injection , while it was less in the SCC group. This difference was statistically significant(p<0.05). In conclusion, complete corpus callosotomy had contributed to the protective effect on the development of status epilepticus in the lithium-pilocarpine model which was similar to that observed in humans. And result of Fos expression suggest that Fos immunohistochemisty may be useful in the study of seizure pathways as a metabolic marker in the lithium-pilocarpine model.
Animals ; Cerebral Cortex ; Electroencephalography ; Epilepsy ; Humans ; Rats* ; Rats, Sprague-Dawley ; Seizures ; Status Epilepticus

Fifteen cases of diffuse axonal injury(DAI) brought about by nonmissile head injury in humans are analyzed. All cases were subjected to comprehensive clinical studies such as measurement of cerebral blood flow by SPECT, continuous intracranial pressure monitoring and multimodality evoked potentials(MEPs). In the patients with DAI, a high incidence of low cerebral perfusion and abnormal MEPs. especially auditory evoked potentials, were found, with high incidence of high velocity traffic accident injury mechanism. On the other hand, a low incidence of increased intracranial pressure was found and dehydrating agents such as glycerol and mannitol did not exert a beneficial influence upon the clinical courses or the outcomes. The outcome of the patients with DAI depended upon the duration of coma and whether or not brain stem signs were noted.
Accidents, Traffic ; Axons ; Brain Stem ; Coma ; Craniocerebral Trauma ; Diffuse Axonal Injury* ; Evoked Potentials* ; Evoked Potentials, Auditory ; Glycerol ; Hand ; Humans ; Incidence ; Intracranial Pressure* ; Mannitol ; Perfusion ; Tomography, Emission-Computed, Single-Photon

Twenty eight year-old male with 3 year history of radiating pain to both thighs and thirty six year-old female with one year history of perineal hypesthesia and constipation were presented. The clinical features, radiologic features, surgical techniques and complications are described. In both cases, postoperative cerebrospinal fluid leakage was developed and managed successfully with lumbar drainage and rest respectively. The preoperatively presented symptoms were completely disappeared after surgery.
Cerebrospinal Fluid ; Constipation ; Drainage ; Female ; Humans ; Hypesthesia ; Male ; Thigh

Renal osteodystrophy has become a frequent complication in patients with chronic renal failure (CRF), and various histologic forms such as high turnover, low turnover and mixed bone disease have been demonstrated. The only reliable method for distinguishing patients with high turnover from those with low turnover bone disease is bone histomorphometric study, but its clinical utility is restricted. Because of its invasive nature, efforts have been made to predict indirectly the type and severity of thi metabolic bone disease by serum assays. In this cross-sectional study, we measured total and regional (head, arms, trunk, ribs, legs, spine and pelvis) bone mineral densities (BMD) by dual X-ray absorptiometry (DXA) in patients with variable degrees of CRF and correlated them with various bone markers. Decreased BMDs were detected in various skeletal sites (trunk and pelvis) in the patients' group. Total BMD Z score was lower in predialysis CRF patients than in the control subjects. Decreased BMD Z scores on weight-bearing bone were pronounced at L1 lumbar vertebra, femur trochanter, femur neck and Ward's triangle. Positive linear correlations were found between creatinine clearance and trunk, ribs, pelvis, and spine BMDs. There were inverse linear correlations between total BMD and total BMD Z score and alkaline phosphatase (AP), urine deoxypyridinoline (U-DPD) in the patients' group. There were no correlations between regional and total BMD, total BMD Z score and serum calcium, ionized calcium, and serum phosphate. There were inverse linear correlations between BUN, creatinine and bone-specific alkaline phosphatase in the predialysis CRF group. We evaluated the correlations between intact parathyroid hormone (i-PTH) and biochemical and other bone markers. There was statistically significant linear correlation between i-PTH and AP. Other bone markers have no significant correlations with i-PTH. Our results demonstrated that there is significant bone loss in patients with CRF before the start of dialysis and also regional variations of BMDs in predialysis CRF patients. DXA is a useful method for evaluating regional and total BMDs and provides information about diverse regional skeletal changes. AP, i-PTH and U-DPD can predict BMD of predialysis CRF patients.
Alkaline Phosphatase/blood ; *Bone Density ; Cross-Sectional Studies ; Female ; Human ; Kidney Failure, Chronic/*metabolism ; Male ; Parathyroid Hormones/blood ; Support, Non-U.S. Gov't

Renal osteodystrophy has become a frequent complication in patients with chronic renal failure (CRF), and various histologic forms such as high turnover, low turnover and mixed bone disease have been demonstrated. The only reliable method for distinguishing patients with high turnover from those with low turnover bone disease is bone histomorphometric study, but its clinical utility is restricted. Because of its invasive nature, efforts have been made to predict indirectly the type and severity of thi metabolic bone disease by serum assays. In this cross-sectional study, we measured total and regional (head, arms, trunk, ribs, legs, spine and pelvis) bone mineral densities (BMD) by dual X-ray absorptiometry (DXA) in patients with variable degrees of CRF and correlated them with various bone markers. Decreased BMDs were detected in various skeletal sites (trunk and pelvis) in the patients' group. Total BMD Z score was lower in predialysis CRF patients than in the control subjects. Decreased BMD Z scores on weight-bearing bone were pronounced at L1 lumbar vertebra, femur trochanter, femur neck and Ward's triangle. Positive linear correlations were found between creatinine clearance and trunk, ribs, pelvis, and spine BMDs. There were inverse linear correlations between total BMD and total BMD Z score and alkaline phosphatase (AP), urine deoxypyridinoline (U-DPD) in the patients' group. There were no correlations between regional and total BMD, total BMD Z score and serum calcium, ionized calcium, and serum phosphate. There were inverse linear correlations between BUN, creatinine and bone-specific alkaline phosphatase in the predialysis CRF group. We evaluated the correlations between intact parathyroid hormone (i-PTH) and biochemical and other bone markers. There was statistically significant linear correlation between i-PTH and AP. Other bone markers have no significant correlations with i-PTH. Our results demonstrated that there is significant bone loss in patients with CRF before the start of dialysis and also regional variations of BMDs in predialysis CRF patients. DXA is a useful method for evaluating regional and total BMDs and provides information about diverse regional skeletal changes. AP, i-PTH and U-DPD can predict BMD of predialysis CRF patients.
Alkaline Phosphatase/blood ; *Bone Density ; Cross-Sectional Studies ; Female ; Human ; Kidney Failure, Chronic/*metabolism ; Male ; Parathyroid Hormones/blood ; Support, Non-U.S. Gov't

Short-chain acyl-CoA dehydrogenase deficiency (SCADD; OMIM # 201470) is an autosomal recessive inborn error of mitochondrial fatty acid beta-oxidation, presenting with a variety of clinical signs and symptoms. Developmental delay, hypertonia or hypotonia, ketotic hypoglycemia, and epilepsy are most frequently reported. In general, patients diagnosed through newborn screening have shown normal growth and development in contrast to those diagnosed as a result of clinically initiated evaluations. Here, the case of an asymptomatic Korean newborn with SCADD identified by tandem mass spectrometry is reported. The patient showed an elevated concentration of butyrylcarnitine detected on newborn screening. Urinary excretion of ethylmalonic acid was elevated by urine organic acid analysis. To confirm the diagnosis of SCADD, a direct sequencing analysis of 10 coding exons and the exon-intron boundaries of the ACADS gene were performed. Genetic analysis of ACADS showed the following novel compound heterozygous missense mutations: c.277C>A (p.Leu93Ile) on exon3 and c.682G>A (p.Glu288Lys) on exon6. These results will provide further evidence of mutational heterogeneity for SCADD.
Acyl-CoA Dehydrogenase ; Butyryl-CoA Dehydrogenase ; Carnitine ; Clinical Coding ; Databases, Genetic ; Epilepsy ; Exons ; Growth and Development ; Humans ; Hypoglycemia ; Infant, Newborn ; Malonates ; Mass Screening ; Muscle Hypotonia ; Population Characteristics ; Tandem Mass Spectrometry