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The Safety and Efficacy of Cadaveric Allografts and Titanium Cage as a Fusion Substitutes in Pyogenic Osteomyelitis

  • Kim, Hyun-Woo;Ryu, Je-Il;Bak, Koang-Hum
    • Journal of Korean Neurosurgical Society
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    • v.50 no.4
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    • pp.348-356
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    • 2011
  • Objective : The safety and efficacy of various fusion substitutes in pyogenic osteomyelitis has not been investigated. We evaluated and compared the cadaveric allograft and titanium cages used to reconstruct, maintain alignment and achieve fusion in the management of pyogenic spinal infection. Methods : There were 33 patients with pyogenic osteomyelitis underwent fusion in this study. Fifteen of the 33 patients were operated on by fusion with allografts (cadaveric patella bones) and 18 of those were operated with titanium mesh cages filled with autologous cancellous iliac bone. After the affected disc and vertebral body resection with pus drainage, cadaveric allograft or titanium cages were inserted into the resected space. Posterior transpedicular screw fixation and rod compression in resected space, where cadaveric allograft or titanium cages were inserted, was performed to prevent the malposition in all patients except in 1 case. Recurrent infection was identified by serial erythrocyte sedimentation rate and cross reactive protein follow-up. Osseous union and recurred infection available at a minimum of 2 years following operation was identified. The amount of kyphosis correction and the subsidence were measured radiographically. Results : Spinal fusion was achieved in 29 of 33 patients. In the cadaveric allograft group, 93.3% of patient (14 of 15) showed the osseous union while 83.3% of patient (15 of 18) in the titanium cage group showed union. Subsidence was noted in 12 of the patients. Twelve patients (36.3%) showed unsettling amounts of subsidence postoperatively whereas 46.6% of patients in the cadaveric allograft group and 37.7% of patients in the titanium cage group showed similar subsidence, respectively. There were statistical difference in the fusion rate (p=0.397) and subsidence rate (p=0.276) between the two groups. There was significant statistical difference in the postoperative improvement of segmental kyphosis between the two groups (p=0.022), that is the improvement in sagittal alignment was greater in the titanium cage group than in the cadaveric allograft group. There was no case of recurred infection. Conclusion : The cadaveric allograft and titanium cages are effective and safe in restoring and maintaining sagittal plane alignment without increased incidence in infection recurrence in pyogenic osteomyelitis. The postoperative improvement of segmental kyphosis was better in the cage group.

Study on Literatures of Symptoms and Signs of Tussiculaltion on Treatise on the Pathogenesis and Manifestations of All Diseases ("제병원후론(諸病源候論)" 중(中) "해수병제후(咳嗽病諸候)"에 대(對)한 연구(硏究))

  • Lee, Nam-Goo;Choi, Han-Baek;Kim, Jeong-Wan;Song, Min-A
    • Journal of Korean Medical classics
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    • v.23 no.5
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    • pp.11-22
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    • 2010
  • Treatise on the Pathogenesis and Manifestations of All Diseases(諸病源候論)was written by Chao Yuanfang that was most active during the Sui Dynasty at A.D. 610. It classified clinical medicine by some departments of internal medicine, surgery, obstetrics and gynecology, pediatrics, and otorhinolaryngology and within each specific department, categorizes etiology and pathology according to characteristics of various diseases. It was the total disease classification book that based on the bibles of the Oriental medicine, (Huangdi''s) Internal Classic(黃帝內經), Classic of Difficult Issues(難經) and Treatise on Cold Damage and Miscellaneous Diseases(傷寒雜病論), A-B Classic of Acupuncture and Moxibustion(鍼灸甲乙經), Essential Prescriptions Worth a Thousand Gold for Emergencies(備急千金要方) and Medical Secrets of an Official(外臺秘要). It was arranged tussive causes, classes, diagnosis, prognosis and stretching for treatment by Volume 13, all symptoms of tussiculation. Dialectic part was divided into cough(咳嗽), cough with dyspnea(咳逆上氣), cough with pus and blood(咳嗽吐膿血), cough with duck crying sound(?嗽), sudden cough(暴氣咳嗽), cough with dyspnea(咳逆), cough with dyspnea and vomiting(咳逆上氣嘔吐). Disease situation part was divided into the new cough(新咳) and old cough(舊咳), deficiency syndrome(虛證) and excess syndrome(實證), visceral cough(藏府咳), etc. Out of these, cough with counterflow(咳嗽上氣), cough with dyspnea(咳逆上氣), cough with dyspnea and vomiting(咳逆上氣嘔吐), cough with shortness of breath(咳逆短氣) have a close connection with dyspnea(上氣), counterflow of qi(逆氣), dyspnea and vomiting(上氣嘔吐) and shortness of breath(短氣) in the Pathogenesis and Manifestations of All qi(氣病諸候) of vol 13. So two parts may be refer to each other. However, the content on the original book has been addition and subtraction on the original context along with many reprints. Therefore, this paper, with regard to the prints of former editions, tried to help in better comprehension of the original context through readings and Korean translation.

Apo Taq expression on salivary glands by the restraint stress in Rat (구속 스트레스에 대한 백서 타액선의 Apo Taq 발현)

  • Cho, Sung-Kuk;Kang, Soo-Kyung;Auh, Q-Schick;Chun, Yang-Hyun;Hong, Jung-Pyo
    • Journal of Oral Medicine and Pain
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    • v.38 no.4
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    • pp.291-298
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    • 2013
  • On this study, we treated rats with restraint stress, and observed the changes with an optical microscope. Within the salivary gland tissue, we measured cell apoptosis cycle evaluation which show positive reaction on TUNEL assay, and compared within the groups. For this study, 18 rats were divided into 3 groups; 1) 2 rats of group I were selected as a normal control. 2) 2 rats of group II, as a experimental control were placed in the restraint cone for 2 hours 3) 14 rats of group III were placed in the restraint cone for 2 hours once a day. The rats were sacrificed immediately (group II, as a experimental control), 1, 2, 3, 4, 5, 6 and 7days after application of the stress and the both parotid glands were excised. The conclusions follow. 1. 5 days after giving an confining stress to the parotid gland of Rats, we can observe the hypotropy and pus and inflammation of Rat parotid gland acinar cells, and after 7 days, we can see a cell apoptosis. 2. Through the In situ DNA end labeling assay and TUNEL dye, on serous glands, benign tumor cell increased with statistically significant result after 5 days from confining stress. And the index shows maximum value on 7th days, which is same result with histological opinion. Therefore, our study shows that a cell apoptosis can be induced by restraint stress on salivary gland tissue, and we think more study should be accomplished about the cell signaling pathway in the future.

CAVERNOUS SINUS THROMBOSIS : A CASE REPORT (해면 정맥동 혈전증(Cavernous Sinus Thrombosis) 치험례)

  • Chang, Hyun-Suk;Jang, Myung-Jin;Kim, Yong-Kwan;Kim, Kyoung-Won
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.17 no.4
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    • pp.447-455
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    • 1995
  • Cavernous sinus thrombosis is one of the major complications of abscesses of the maxillofacial region. The initial symptoms of CST are usually pain in the eye and tenderness to pressure. this is associated with high fluctuating fever, chills, rapid pulse, and sweating. Venous obstruction subsequently causes edema of the eyelids, lacrimation, proptosis, chemosis and retinal hemorrhages. Blindness is sometimes an accompaniment of cavernous sinus thrombosis when the infection also involves the orbit. There is also cranial nerve involvement (oculomotor, troclear, abducence) and ophthalmoplegia, diminished or absent corneal reflex, ptosis, and dilation of the pupil occur. The terminal stages bring signs of advanced toxemia and meningitis. Infections of the face can cause a septic thrombosis of the cavernous sinus. Furunculosis and infected hair follicles in the nose are frequent causes. Extractions of maxillary anterior teeth in the presence of acute infection and especially curettage of the sockets under such circumstances can cause this condition. The infection is usually staphylococcal. The inflection may spread directly through the pterygoid plexus of veins and the pterygomaxillary space and then ascend into the sinus or it may spread directly from the pterygopalatine space to the orbit. This is possible because of the absence of valves in the angular, facial, and ophthalmic veins. The treatment is empirical antibiotic therapy followed by specific anbibiotic therapy based on blood or pus culture. The inflection usually involves one side, however, it may easily spread to the opposite side through the circulus sinus. Unless it is treated early, the prognosis is poor even in this doses. Occasionally the antibiotics will not adequately resolve the septic thrombus, and death ensues. the use of anticoagulants to prevent venous thrombosis has been recommended, but the efficacy of such therapy has not been substantiated. Surgical access through eye enucleation has been suggested. We report a case which demonstrates cavernous sinus thrombosis by the infection after the functional neck dissection and the intraoral reconstruction with auriculomastoid fascio-cutaneous island flap.

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Effective Identification of Ochrobactrum anthropi Isolated from Clinical Specimens (임상검체에서 분리된 Ochrobactrum anthropi의 효과적인 동정)

  • Ko, Hyun-Mi;Jo, Jun-Hyeon;Baek, Hae-Gyeong
    • Korean Journal of Clinical Laboratory Science
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    • v.52 no.3
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    • pp.221-228
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    • 2020
  • Ochrobactrum anthropi is a non-fermentative oxidative gram-negative bacillus that produces oxidase. Distinguishing a mixed culture with non-fermenting bacteria having a similar appearance and oxidase-positive is difficult, and there is a limit to accurate identification with a biochemical identification system. This paper proposes that the Matrix-Assisted Laser Desorption/Ionization Time-of-Flight Mass Spectrometry Platform (MALDI-TOF) method is useful for classifying bacteria that are difficult to identify using biochemical testing methods. As a result of analyzing five cases of O. anthropi examined using MicroScan, it took 6.5 days to the final report, which was 3.5 days more than the 3.0 days of E. coli. The pus sample in patient 5 was a mixed infection with Achromobacter xylosoxidans, and it took 11.3 days because of multiple subculture and retests. Four patients were over 60 years old with an underlying disease, and the possibility of opportunistic and nosocomial infections could not be excluded. Among them, samples collected after 92 days of hospitalization were resistant to imipenem and meropenem. Therefore, an examination using the MALDI-TOF method will be useful for the rapid and adequate treatment of patients with difficult identification, such as O. anthropi.

Klebsiella Pneumonia-Necrotizing Fasciitis followed by Liver Abscess (폐렴 간균-괴사성 근막염에 이어 발생한 간농양)

  • Lee, Seung Hyun;Choi, Jeong Woo;Lee, Myeung Su
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.6
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    • pp.427-431
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    • 2018
  • We report a case of a patient with necrotizing fasciitis followed by liver abscess. A 51-year-old man was admitted to our hospital with a 5-day history of fever and chills with painful swelling of the right thigh. A magnetic resonance imaging (MRI) scan showed fluid collection with numerous dark signal intensities considered as air-bubbles between the posteromedial and posterolateral groups of the right thigh, resulting in presumptive diagnosis of necrotizing fasciitis. At the time of admission, an ultrasonograph of the abdomen showed increased parenchymal echogenicity of both kidneys and no liver abscess. Ten days after fasciotomy, an abdominal computed tomography (CT) scan showed intrahepatic abscess. Sonography-guided percutaneous drainage was performed. Both cultures of pus specimens from the liver abscess and right thigh yielded Klebsiella pneumoniae (K. pneumoniae). The patient was treated with fasciotomy several times and parenteral antibiotics, after which he began to improve. After 5 weeks, liver abscess size was reduced, and after 10 weeks, liver abscess disappeared. To the best of our knowledge, this is the first case of K. pneumoniae-necrotizing fasciitis followed by liver abscess.

A acupuncture therapy literature study on the hemorrhoids and hemorrhoids complicated by anal fistula (치창(痔瘡)과 치루(痔漏)에 대한 침구학적(鍼灸學的) 문헌고찰(文獻考察))

  • Song, Won-sub;Lee, Byung-ryul;Lee, Hyun;Chae, Sang-jin
    • Journal of Acupuncture Research
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    • v.20 no.1
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    • pp.131-143
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    • 2003
  • Objective : The purpose of this study is to arrange the literature about acupuncture therapy on the hemorrhoids and hemorrhoid complicated by anal fistula. Methods : We arrange Huang Di Nei Jing and fifteen kinds of literature about the hemorrhoids and hemorrhoid complicated by anal fistula. Results : 1. The cause of hemorrhoids are overfatigue, overeating, imbalance of stool(const-ipation or diarrhea), uncontrol sexual excess or abstinence, pathgenic factors of wetness, heat, wind, dry, fire, chronical hemorrhoids that has not been treated, and general weakness. 2. Symptom of hemorrhoids is that skin is projected form the nine holes or varicose extension to become hemorrhoid. Hemorrhoids is small nodosity that projected on the anal inter or outer region, and hemorrhoid complicated by anal fistula is pus which comes out form one or some fistula on the anal around inter and outer region. 3. Therapy method of hemorrhoid and hemorrhoid complicated by anal fistula are elimination pathological heat from blood, promote blood flow to remove blood stasis, cold in nature and purge away fire, remove heat form the blood, promote blood flow to remove blood stasis, cold in nature and purge away fire, remove heat from the blood and eliminate dampness, tonify the spleen and replenish Ki, dispel wind and alleviate pain and so forth. Therapy method of hemorrhoid is to give the first consideration to relieve blood: eliminating pathological heat form blood complicated by anal fistula is to tonify the blood first, than after that eliminating pathological heat form blood. About external method are method of fumigation, method of ointment, method of close with medicine, necrotizing method and also operation(injection, bind etc.)was used for treatment. 4. The prescription are Gurgak-hwan, Wypi-hwan, Gunggyi-tang, Jingyochangchul-tang, Jingyobangpung-tang, Mokhyangbinrang-hwan, Ochi-san, Gamihyanso-san, Jojang-hwan, Sinyung-hwan used frequently. 5. food taboo on patient's diet of the hemorrhoid and hemorrhoid complicated by anal fistula are raw grain, cold or dampness food, alcohol, hot food, Singiberis rhizoma recens, Cinnamomi ramulus. 6. Acupuncture therapy on the hemorrhoid and hemorrhoid complicated by anal fistula are, in the first stage eliminating pathological heat form blood and eliminate dampness, and in the long term eliminate dampness, promote and remove meridian energy, remove that form the intestines, dispel channels and collaterals. 7. Acupuncture points at B2, CV1, B58, B36, B56, Sp5, S30, B25, B54, GV1, GV20, L6, B40 used frequently for the acupuncture therapy, and acupuncture point at GV4, GV1, B30, hemorrhoidal point used form moxibustion. Reduction blood at B40 and blue capillary of Sp9 and acupuncture Chungbaek, Ki-gack, Ki-jung, Ki-mun(Dongsh Kihyel) makes the treatment very effective.

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A Chromosomal Study on the Genus Cobitis (Pisces : Cobitidae) in the Southern Part of Korea (한국 남부지방에 서식하는 기름종개속(Cobitis) 어류의 핵형 비교)

  • KIM Ik-Soo;LEE Ji-Hyun
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.19 no.3
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    • pp.257-264
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    • 1986
  • The Chromosomes of five cobitid fishes, Cobitis taenia taenia, C. taenia lutheri, C. taenia striata, C. longicorpus and C. koreensis were studied. The karyotypic studies were based on the observations from the flame-drying preparations. The results obtained such as the number of somatic chromosomes, the type of chromosomes according to the centromeric loci and the number of chromosomal arm(AN) were as follows: C. longicorpus, 2n=50, 12m-8sm-30a, AN=70; C. koreensis, 2n=50, 10m-12sm-28a, AN=72; C. taenia taenia, 2n=48, 14m-4sm-30a, AN=66: C. taenia lutheri, 2n=50, 10m-6sm-34a, AN=66; and C. taenia striata, 2n=50, 10m-6sm-34a, AN=66. Peculiarly, in the case of C. taenia lutheri the chromosome number of somatic diploid was found to be 48-51, however, the number of chromosomal arm was 66, irrespective of the difference in the numbers of each somatic genome. It was confirmed there exists the Robertsonian event, one of the chromosomal polymorphism in C.t. lutheri. It was remarked taxonomically that the karyotype of C. taenia taenia of Korea having 48 diploid chromosomes was not identical with that of Europe and Japan with 50 chromosomes. Based on the karyotype analysis the Korean cobitid fishes can be classified roughly into three species groups according to arm numbers and diploid numbers; 1) C. taenia taenia, C. taenia lutheri, C. taenia striata 2) C. koreensis, C. longicor pus, C. rotundicaudata and 3) C. granoei.

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Tibiotalocalcaneal Arthrodesis Using Ipsilateral Distal Fibula Buttress (동측 원위 비골 지주를 이용한 경-거-종골 관절 유합술)

  • Cho, Se-Hyun;Lee, Jung-Su;Jeong, Seon-Taek;Park, Hyung-Bin;Hwang, Sun-Chul;Jeong, Jae-Hyon;Cha, Min-Suok
    • Journal of Korean Foot and Ankle Society
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    • v.10 no.2
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    • pp.213-217
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    • 2006
  • Purpose: To evaluate the clinical and radiological results of tibio-talo-calcaneal arthrodesis using ipsilateral distal fibula buttress which had advantages of extended operative field and release of contracted soft tissue. Materials and Methods: We retrospectively reviewed 4 postraumatic compartment syndrome, 2 residual poliomyelitis, 1 posttraumatic osteoarthritis with subtalar joint infection and 1 posttarumatic sciatic nerve palsy patients who underwent a tibio-talo-calcaneal arthrodesis from April, 1996 to March, 2002. Each of the cases was notable for a severe rigid equinovarus, persistent pus drainage of calcaneal area and paralytic foot. The mean duration of follow up was 18 months (range, $13{\sim}42$ months). The pain, function and alignment were evaluated by the modified ankle hindfoot scale of the American Orthopaedic Foot and Ankle Society (AOFAS) and patients satisfaction clinically. The radiological union were evaluated by plain AP and lateral radiographs. Results: The AOFAS score improved from 58 points (range, $47{\sim}78$) preoperatively to 82 (range, $60{\sim}89$) postoperatively. Patents satisfaction checked at 12 months after operation had favorable results (excellent and good 80%). Union rate was 100% radiographically and the mean duration of union was 12.5 weeks (range $8{\sim}22$ weeks). There was 2 cases of superficial pin tract infection and one protrusion of screw. Conclusion: Tibio-talo-calcaneal arthrodesis using ipsilateral distal fibula buttress was good modality of arthrodesis which provides wide operative field and release of contracted soft tissue in some cases of contracted foot.

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The Relationship between Public Support for Scientific Research and Political Orientations: The Case of Research for Social Problem-Solving (과학기술에 대한 일반시민의 지지도와 정치의식: 사회문제 해결형 연구를 중심으로)

  • Bak, Hee-Je;Kim, Myungsim
    • Journal of Technology Innovation
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    • v.24 no.3
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    • pp.107-137
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    • 2016
  • By analyzing a nationwide survey on Korean publics, this study examines the social determinants of public support for three types of scientific research-basic research aimed at pure knowledge, applied research toward industrial application, and research for social problem-solving which aims to enhance ordinary citizens' quality of life. The present study finds the differential effects of social- and political value orientations on the level of public support for respective types of research. As ones have more progressive in their subjective political orientations, they are more likely to support research for social problem-solving than other types of research, while conservatives tend to support basic research and those with neo-liberal ideology tend to support applied research. The Korean public also tends to perceive research for social problem-solving as a counter to basic research while it has been developed against the conventional emphasis on applied research in Korea. Also, the level of support for research for social problem-solving increases with the higher level of trust in scientific authority and expertise, while it has been developed against expertism and included public engagement in science as an important element. Finally, those who have lower income tend to support for research for social problem-solving than other types of research. The implications of these findings are discussed.