A Case of Psoas Abscess Due to Candida albicans / 감염과화학요법

Candida species are ubiquitous human commensals, of which Candida albicans is most commonly associated with human disease. Candida infections usually involve superficial tissues, but the infections of deep tissues are relatively uncommon. Among the candida infections of deep organs, disseminated candidiasis is the most common presentation particularly in immunosuppressed patients, however, a single abscess formation in deep organ is rare. We experienced a case of psoas abscess by C. albicans in a patient who had diabetes and alcoholic liver cirrhosis, which was treated successfully by drainage of the abscess and administration of amphotericin-B, followed by fluconazole. We report this case with review of the pertinent literatures.

A Case of Psoas Abscess Due to Candida albicans / 감염과화학요법

Candida species are ubiquitous human commensals, of which Candida albicans is most commonly associated with human disease. Candida infections usually involve superficial tissues, but the infections of deep tissues are relatively uncommon. Among the candida infections of deep organs, disseminated candidiasis is the most common presentation particularly in immunosuppressed patients, however, a single abscess formation in deep organ is rare. We experienced a case of psoas abscess by C. albicans in a patient who had diabetes and alcoholic liver cirrhosis, which was treated successfully by drainage of the abscess and administration of amphotericin-B, followed by fluconazole. We report this case with review of the pertinent literatures.

A Case of Common Bile Duct Web Presenting with Obstructive Jaundice without Choledocholithiasis / 대한소화기내시경학회지

Biliary web is an extremely rare disease. It has been reported about 40 cases worldwide and 7 cases in Korea. Most cases have been incidentally found at operation or autopsy because of its rare incidence and absence of specific clinical manifestations. On cholangiography, billiary web typically appears as slit like or shelf like radiolucent narrowing. We experienced a case of biliary web of the common bile duct with obstructive jaundice that was diagnosed by endoscopic retrograde cholangiopancreatography and treated by surgery in a 65 year-old male who complained of right upper quadrant pain for 4 days. We report a case of biliary web of the common bile duct with obstructive jaundice with a review of the literature.

Glutathione Levels in Helicobacter pylori-infected Gastric Mucosa / 대한소화기학회지

BACKGROUND/AIMS: Oxidative stress may contribute to gastric epithelial damage and mutagenesis caused by Helicobacter pylori (H. pylori). H. pylori induces recruitment and activation of inflammatory cells, which produces reactive oxygen species. H. pylori extract directly induces the synthesis of reactive oxygen species in gastric epithelial cells and causes DNA damage. The aim of this study was to investigate the association between the levels of glutathione (GSH) and H. pylori density, histological findings, endoscopic findings, clinical variables, and virulence factors. METHODS: Gastric biopsy specimens were obtained from 73 consecutive patients. The 5,5'-dithiobis-(2-nitrobenzoic acid) reaction was used to determine GSH levels. RESULTS: The infection rate of H. pylori was 68.5%. The GSH level was not related to age, sex, alcohol intake, and endoscopic findings. The GSH level was lower in patients infected with H. pylori. GSH levels were not correlated significantly with the grades of neutrophil, intestinal metaplasia, and atrophy. However, the GSH levels were significantly correlated with H. pylori density (r=-0.296, p=0.01) and monocyte grade (r=-0.257, p=0.02). The GSH levels were not related to CagA, VacA, and UreA. CONCLUSIONS: This study suggests that H. pylori causes oxidative stresses which deplete GSH in gastric mucosa of patients infected with H. pylori.

Glutathione Levels in Helicobacter pylori-infected Gastric Mucosa / 대한소화기학회지

BACKGROUND/AIMS: Oxidative stress may contribute to gastric epithelial damage and mutagenesis caused by Helicobacter pylori (H. pylori). H. pylori induces recruitment and activation of inflammatory cells, which produces reactive oxygen species. H. pylori extract directly induces the synthesis of reactive oxygen species in gastric epithelial cells and causes DNA damage. The aim of this study was to investigate the association between the levels of glutathione (GSH) and H. pylori density, histological findings, endoscopic findings, clinical variables, and virulence factors. METHODS: Gastric biopsy specimens were obtained from 73 consecutive patients. The 5,5'-dithiobis-(2-nitrobenzoic acid) reaction was used to determine GSH levels. RESULTS: The infection rate of H. pylori was 68.5%. The GSH level was not related to age, sex, alcohol intake, and endoscopic findings. The GSH level was lower in patients infected with H. pylori. GSH levels were not correlated significantly with the grades of neutrophil, intestinal metaplasia, and atrophy. However, the GSH levels were significantly correlated with H. pylori density (r=-0.296, p=0.01) and monocyte grade (r=-0.257, p=0.02). The GSH levels were not related to CagA, VacA, and UreA. CONCLUSIONS: This study suggests that H. pylori causes oxidative stresses which deplete GSH in gastric mucosa of patients infected with H. pylori.

Real Time Three-Dimensional Echocardiographic Detection of Acquried Left Ventricular-Right Atrial Communication (Gerbode-Type Defect) Caused by Infectious Endocarditis

Left ventricular-right atrial communications, known as Gerbode-type defects, are rare intracardiac defects that can be either congenital or acquired. Acquired forms arises from endocarditis, trauma, mitral or aortic valve replacement and myocardial infarction. In this case, a forty-seven year-old man with resting dyspnea and fever was diagnosed to have infected congenital bicuspid aortic valve resulting in severe acute aortic regurgitation and he also was diagnosed to have a Gerbode-type defect which were demonstrated by the color doppler method and realtime three-dimensional echocardiography. The causasive organism was Streptococcus mitis. After sufficient antibiotics therapy, aortic valve replacement was performed and the atrioventricular portion of the membranous septum was closed directly with mattress suture. We also review the anatomical features and hemodynamic consequences of such a defect.

Multifocal eosinophilic granuloma in 6th decade: a case report / 대한정형외과학회잡지

No abstract available.

Osteoblastoma in lumbar spine: a case report / 대한정형외과학회잡지

No abstract available.

Clinical Study of Arthrogram in Ankle Fracture / 대한정형외과학회잡지

The Ankle joint is a modified complex hinge joint which plays an importnat role in weight bearing, walking and standing. Injuries about the ankle joint cause destruction of not only bony architecture but also the ligament and soft tissue components. We performed arthrography in 52 cases of ankle fracture. The Result obtained from this study was as follow; The ligament & interosseous membrane injuries were more severe, when fracture of lateral malleolus was occured higher level than ankle joint.

Chevron Osteotomy for the Treatment of hallux Valgus / 대한정형외과학회잡지

Hallux valgus has been defined as a static subluxation of the first metatarsophalangeal joint with lateral deviation of the proximal phalanx on the first metatarsal head from the longitudinal axis of the first metatarsal with medial deviation of the first metatarsal. And first-second metatarsal angle is increased as well as bursal hypertrophy over the medial eminence of the first metatarsal head. Many procedures have been reported for the treatment of the hallux valgus ranging from resection arthroplasty to distal first metatarsal or basal first metatarsal osteotomy. Of these, Johnson and Corless have required sufficiently good results in the modifying Mitchell osteotomy into Chevron osteotomy. The Chevron procedure is an osteotomy involving the distal portion of the first metatarsal, lateral displacement of the metatarsal head with exostosectomy, and tightening of the medial capsular structures. Authors studied 17 cases in 10 patients with the hallux valgus deformity treated by Chevron osteotomy at the Department of Orthopedic Surgery, Capital Armed Forced General Hospital from September 1987 to September 1989. The results were as follows; 1. Seven patients (12 cases) were male and three patients (5 cases) were female. All patients had bilateral hallux valgus deformity. 2. The average first-second intermetatarsal angle was 11 degrees and average valgus angle was 32 degrees, preoperatively. They were corrected to 9 degrees and 14 degrees respectively. 3. The metatarsalgia of the great toe was subsided in all cases and they were satisfied with the result of their operations in respect to cosmetically and functionally. Avascular necrosis of capital fragment, nonunion, and dorsal angulation were not developed in any case. But, one case had marginal skin necrosis, presumably due to excessive compressive dressing. 4. Chevron osteotomy is a technically easy procedure and it can be obtained early bone healing with less complication.

Old Unreduced Isolated Anterior Dislocation of Radial Head: Report of 2 Cases / 대한정형외과학회잡지

Isolated radial head dislocation, without an associated fracture of the ulna in adult, is rare. Two cases which can be thought as old unreduced isolated radial head dislocation were experienced in this hospital. Dislocated radial heads have not been reduced, however the cases revealed normal elbow motion including pronation and supination. We report these cases with a review of the literature.

Synovial Sarcoma in the Calf Muscle Fascia: A Case Report / 대한정형외과학회잡지

Synovial sarcoma is an uncommon, highly malignant soft tissue tumor usually arising from the synovial lining of a joint, bursa and tendon sheath. Occurence in muscle fascia is extremely rare. We present a case of synovial sarcoma of the left calf muscle fascia, which was confirmed by microscopically sarcomatous growth of spindle cells and irregular small multiloculation. Above knee amputation was done.

A Familial Osteopetrosis / 대한정형외과학회잡지

Osteopetrosis is a very rare bone dysplasia characterized by failure of resorption and persistence of calcified chondroid and primitive bone. In 1904 Albers-Schonberg first described the radiological appearance of marble bone. This is named osteopetrosis by Karshner in 1926. A fulminating form is manifested from birth in which fractures and deformity, hydrocephalus and cranial nerve palsies lead to early death from intractable anemia and intercurrent infection. In other cases the stigmata are delayed until later childhood, when retardation of growth and of mental and sexual development occurs, and not infrequently accompanied by rickets, dental caries and osteomyelitis. We have experienced a familial osteopetrosis, father and three siblings, which was thought to be a autosomal dominant inheritance. One of those family, 20 years old man, has been complained of anemia and low back pain without radiating pain to the lower extremities. The other 3 patients has not been complained of any other clinical symptoms. But X-Ray examination of the entire skeletal survey of those members of the family have revealed the uniform opacity of long bones and flat bones.

Traumatic Posterior Dislocation of the Sternoclavicular Joint: A case Report / 대한정형외과학회잡지

Dislocation of the clavicle at its sternal end is relatively rare, as compared with acromioclavicular dislocation. Among them, the posterior dislocation of the sternoclavicular joint was extremely rare. So, not more than fifty cases had been reported in the literature. Of these three main typesanterior, superior, and posterior-the anterior one is by far the most common. Most authors have stressed the difficulty in confirming the diagnosis with routine radiographs. We experienced a case of traumatic posterior dislocation of the sternoclavicular joint treated successfully by manipulative reduction. So, we report it with review of literature.

The Use of Flexible Intramedullary Nails in Fracture of the Tibial Shaft / 대한정형외과학회잡지

Forty five cases of adult tibial shaft fractures were treated with flexible intramedullary nails under image intensifier at the department of orthopaedic surgery, Capital Armed Forces General Hospital during between April 1986 to July 1988. The results were summarized as follows: 1. 45 cases were all male, the average age was 24.3 years and the most common cause of fractures was sports injury(20 cases) and the second most common cause was traffic accident(18 cases). 2. 11 cases out of 45 cases were open fracture and 34 cases were closed fracture. Eight cases of open fraeture were grade I and three cases were grade II. Twenty eight cases were comminuted fracture. The most common level of the fracture was middle third of the tibial shaft. 3. Average interval from injury to Ender nailing was 13.5 days and the mean duration of permission to full weight bearing was 9.2 weeks. 4. Out of 2 cases of delayed union, the average time of clinical bone union was 9.7 weeks and that of roentgenological bone union was 14 weeks. 5. 11 cases of complication were noted among the 45 cases of tibial shaft fracture which were treated by PGP nailing such as angulation, rotation, ankle joint stiffness, delayed union, shortening, and soft tissue infection. 6. PGP nailing is considered to be a valuable method in treating tibial shaft fracture because of their relative ease of nailing, allowing early weight bearing and decreased complication.

A clinical Study of Synovial Chondromatosis / 대한정형외과학회잡지

Synovial chondromatosis is a condition of metaplastic and focal formation of cartillage in the intimal layer of synovial membrane. The etiology is unknown. The cartilagenous foci become pedunculated and may be sequestrated into the synovial cavity to form loose body. The center of focus may calcify and ossify. Of the ten cases of synovial chondromatosis experiences by the authors, five cases invo1ved the knee joint, one case both knee joint, two cases the hip joint, two cases the elbow joint, one case the wrist joint. The diagnosis of synovial chondromatosis was made by the histopathological finding of the excised masses.

Midplantar Fasciocutaneous Flap Done for the Defect of the Hinfoot in Explosive Wound / 대한정형외과학회잡지

The hindfoot in the human body is known to play an important function for weight bearng, shock absorption and locomotion. The defect of hindfoot presents serious problems of the leg length discrepancy and weight bearing. Therefore, it is essential to reconstruct the defect of hindfoot. Up to date, many surgical modalities from a skin graft to the innervated osteocutaneous flap have been developed, but a completely satisfactory method of reconstruction has not been found. The ideal reconstructive method should provide sufficient padding tissue and sensibility. In the Department of Orthopaedic Surgery, capital Armed Forces General Hospital, two cases of hindfoot defect due to explosion were reconstructed by the midplantar fasciocutaneous flap with free iliac bone graft. The results of our procedure were very acceptable one year after the operations.

Diagnostic Analysis for Meniscal Lesions of the Knees / 대한정형외과학회잡지

We assessed the accuracy of clinical evaluation, arthrography and arthroscopy in the diagnosis of meniscal lesions in ninty knees in which arthrotomy was performed for disabling symptoms after evaluation by these three methods. At surgery, ninty-two menisci were removed, of which seventy-two were abnormal and twenty were normal. In these ninty-two menisci, correct diagnostic rate was made clinically 78%, arthrographically 70% and arthroscopically 86%. Arthrographic diagnosis was least accurate for lesions of the lateral meniscus and arthroscopic diagnosis was least accurate for lesions of the posterior horn of the medial meniscus and peripheral lesions. Based on this study, it was concluded that both the arthrography and arthroscopy are valuable technique for diagnosis of meniscal lesions.

Intraneural Ganglion of the Common Peroneal Nerve: A Case Report / 대한정형외과학회잡지

A case of intraneural ganglion, 5cm×2cm×1.5cm, which was located between the funiculi of the common peroneal nerve was excised completely under the operative microscope. There was no communication with adjacent bursa or joint.