• Parasites, Hosts and Diseases
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• 제62권1호
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• pp.131-138
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• 2024

Halicephalobus gingivalis is a free-living nematode that occasionally causes infections in horses. We report a rare case of limb fracture of horse caused by infection with H. gingivalis. An 8-year-old mare was referred to the Veterinary Hospital of the Federal University of Lavras with claudication grade 5 of the right hind limb, that had been started 3 months ago. The patient had aseptic arthritis in the tarsal joint and edema that extended to the quartile. The radiographic examination showed punctate osteolysis with exacerbation of bone trabeculation along the calcaneus, talus, proximal epiphysis of the third metatarsal and distal epiphysis of the tibia. Treatment for arthritis was initiated, and the animal showed a slight improvement in limb function. However, 21 days after hospitalization, due to a comminuted fracture of the tibia, it was euthanized. At necropsy, yellowish masses were found from the metatarsal to the tibia, and around the tarsal bones and joint. Similar masses were also found in the left kidney. Numerous nematodes compatible with H. gingivalis were identified. This is the first description of a pathological fracture caused by H. gingivalis infection in an equine limb.

• Journal of Trauma and Injury
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• 제37권1호
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• pp.6-12
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• 2024

Purpose: Open pelvic bone fractures are relatively rare and are considered more severe than closed fractures. This study aimed to compare the clinical outcomes of open and closed severe pelvic bone fractures. Methods: Patients with severe pelvic bone fractures (pelvic Abbreviated Injury Scale score, ≥4) admitted at a single level I trauma center between 2016 and 2020 were retrospectively analyzed. Patients aged <16 years and those with incomplete medical records were excluded from the study. The patients were divided into open and closed fracture groups, and their demographics, treatment, and clinical outcomes were compared before and after 1:2 propensity score matching. Results: Of the 321 patients, 24 were in the open fracture group and 297 were in the closed fracture group. The open fracture group had more infections (37.5% vs. 5.7%, P<0.001) and longer stays in the intensive care unit (median 11 days, interquartile range [IQR] 6-30 days vs. median 5 days, IQR 2-13 days; P=0.005), but mortality did not show a statistically significant difference (20.8% vs. 15.5%, P=0.559) before matching. After 1:2 propensity score matching, the infection rate was significantly higher in the open fracture group (37.5% vs. 6.3%, P=0.002), whereas the length of intensive care unit stay (median 11 days, IQR 6-30 days vs. median 8 days, IQR 4-19 days; P=0.312) and mortality (20.8% vs. 27.1%, P=0.564) were not significantly different. Conclusions: The open pelvic fracture group had more infections than the closed pelvic fracture group, but mortality was not significantly different. Aggressive treatment of pelvic bone fractures is important regardless of the fracture type, and efforts to reduce infection are important in open pelvic bone fractures.

• Pediatric Infection and Vaccine
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• 제3권1호
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• pp.94-100
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• 1996

Streptococcal pneumoniae is the second most coomon cause of meningitis in infancy and a major respiratory pathogen. It is the one of the most common cause of acquired pneumonia and otitis media in childhood. Intracranial extesion of acute otitis media occur somewhat more often from poorly pneumatized than from well-pneumatized temporal bones and in ears with a history of previous attacks of otitis media. We experienced a case of pneumococcal meningitis with 3 time recurrences in a 6 year-old male patient who had hospitalized with high fever, headache, vomiting and stupor mental state. He was diagnosed as CSF study and brain CT. Brain CT showed poorly pneumatized right mastoid region of temporal bone at that time. We report a case of pneumococcal meningitis with 3 time recurrences due to poorly pnematized mastoid region of temporal bone. A review of literatures was also presented briefly.

• Journal of Yeungnam Medical Science
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• 제30권1호
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• pp.55-57
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• 2013

Synovitis acne pustulosis hyperostosis osteitis (SAPHO) syndrome is a rare disease that involves the skin, bones and joints. It is thought to be caused by infection with low-toxicity bacteria and to be the result of reactive infectious osteitis. However, this hypothesis has not yet been clearly established. New SAPHO syndrome treatment methods are needed because the disease does not respond to treatment in many cases. In this paper, a case is reported of SAPHO syndrome with pain in the acromioclavicular joint and with squamous and pustular macules on the palms and soles. First, the patient was treated with aceclofenac, prednisolon and sulfasalazine for two weeks. However, the symptoms were not relieved, so methotrexate and pamidronate were added to the treatment. Since no improvement was seen after four weeks of treatment, adalimumab was prescribed. The skin lesions were relieved two weeks later, and the bone pain and arthralgia, four weeks later. No recurrence or adverse effects were observed at the 22-week follow-up.

• 대한족부족관절학회지
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• 제2권2호
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• pp.97-101
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• 1998

Primary subacute pyogenic osteomyelitis, or Brodie's abscess has received much attention since its initial documentation in the literature in 1832 by Sir Benjamin Brodie. Brodie's abscess is a localized form of chronic osteomyelitis that occurs most often in the metaphyseal area of the long bones of the lower extremities of young adults, Intermittent pain of long duration is the presenting complaint, along with local tenderness over the affected area. Laboratory evaluation is unrevealing, with a normal white blood cell count and differential count. The erythrocyte sedimentation rate may also be normal. Roentgenogram shows a markedly varied appearance and an abscess may be easily mistaken for various neoplasm. The most common organism cultured from abscess is Staphylococcus species. Treatment includes curettage of the lesion and administration of antibiotics. We present a case report (with a 1-year follow-up period), demonstrating the successful surgical treatment of Brodie's abscess of the distal metaphysis of the left tibia caused by Salmonella cholerasuis in a 33-year-0ld male who had no hemoglobinopathy.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제41권6호
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• pp.306-316
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• 2015

Objectives: The facial bones are the most noticeable area in the human body, and facial injuries can cause significant functional, aesthetic, and psychological complications. Continuous study of the patterns of facial bone fractures and changes in trends is helpful in the prevention and treatment of maxillofacial fractures. The purpose of the current clinico-statistical study is to investigate the pattern of facial fractures over a 4-year period. Materials and Methods: A retrospective analysis of 1,824 fracture sites was carried out in 1,284 patients admitted to SMG-SNU Boramae Medical Center for facial bone fracture from January 2010 to December 2013. We evaluated the distributions of age/gender/season, fracture site, cause of injury, duration from injury to treatment, hospitalization period, and postoperative complications. Results: The ratio of men to women was 3.2:1. Most fractures occurred in individuals aged between teens to 40s and were most prevalent at the middle and end of the month. Fractures occurred in the nasal bone (65.0%), orbital wall (29.2%), maxillary wall (15.3%), zygomatic arch (13.2%), zygomaticomaxillary complex (9.8%), mandibular symphysis (6.5%), mandibular angle (5.9%), mandibular condyle (4.9%), and mandibular body (1.9%). The most common etiologies were fall (32.5%) and assault (26.0%). The average duration of injury to treatment was 6 days, and the average hospitalization period was 5 days. Eighteen postoperative complications were observed in 17 patients, mainly infection and malocclusion in the mandible. Conclusion: This study reflects the tendency for trauma in the Seoul metropolitan region because it analyzes all facial fracture patients who visited our hospital regardless of the specific department. Distinctively, in this study, midfacial fractures had a much higher incidence than mandible fractures.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제18권2호
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• pp.177-183
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• 1996

With the increasing esthetic requirement in orthognathic surgeries, midfacial corrective surgeries were developed to improve the paranasal depression. Augmentation with autogenous bones has long been the standard in facial reconstruction, however limited graft availability, donor site morbidity, and difficulties in 3-dimensional shaping were led to limited use. Porous high density polyethylene$(Medpor{(R)})$ was introduced in the 1970s as an alloplastic implants. It can be used in various size and shapes, and shortend operation time. The purpose of this study is to determine, by means of cephalometrics, the degree of long term stability and gaining of the overlying soft tissue thickness. The results were as followings : 1. There was no evidence of foreign body reaction, infection, and tissue necrosis. 2. $(Medpor{(R)})$ implants had an advantage of clinical use ; easy to contour and adapt to obtain a precise 3-dimensional construction. 3. Cephalometric study of 16 cases of paranasal augmentation revealed an overall increase of soft tissue thickness of approximately 82.1% in 6-months following. 4. The successful results could be obtained under the aseptic handling.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제33권3호
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• pp.256-263
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• 2011

Purpose: The purpose of this study was to evaluate the effectiveness of autogenous tooth graft materials after maxillary sinus bone grafts. Methods: The study involved 23 implants in 22 patients who visited the Department of Oral and Maxillofacial Surgery and the Department of Periodontics, Chosun University Dental Hospital, in 2008 and received autogenous tooth graft materials for maxillary sinus bone grafts. Results: For eight patients with maxillary bone graft materials prior to implant placement, the healing period averaged five months. For eleven patients with simultaneous maxillary bone graft and implant placement, eight patients received a second surgery, with an average healing time of six months. Three patients had a longer observation period with only a fixture implanted. Three patients who received only a bone graft required more time to implant placement because of the lack of residual bone and also for personal reasons. Only 5 patients had biopsies performed and complications such as infection and dehiscence healed well. The application of autogenous graft materials to the maxillary bone graft sites did not exert any significant effects on the success rates. When a mixture of graft materials was used, the post-surgical bone resorption rate was reduced. Histological analysis showed that new bone formation and remodeling were initiated during the three-to-six month healing period. Bone formation capacity increased continuously up to six months after the maxillary bone graft. Conclusion: According to this analysis, excellent stability and bone-forming capacity were seen in cases where autogenous materials were used alone or mixed with other materials. Autogenous tooth graft materials may be substituted instead of autogenous bones.

• Archives of Reconstructive Microsurgery
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• 제9권2호
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• pp.147-153
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• 2000

Soft tissue defects of the dorsum of foot and ankle can be covered from skin graft to free tissue transfer. The extent of injury which may be complex including the exposure of paratenons or bones requires free flap reconstruction. Some of the precautions for reconstruction are providing minimal bulkiness and well conforming to irregular contour thus making normal footwear possible. Though the muscle flap having its advantages and versatility, the fascial flap such as temporoparietal fascial flap has been considered the choice for reconstruction of the dorsum of foot and ankle. The purpose of our study is to utilize the advantages and versatility of the muscle flap as a first choice for reconstruction for the defects involving the dorsum of foot and ankle. The gracilis muscle with its anatomic and donor characteristics, it can be utilized to maximal effect by expanding its slim muscle width removing the epimysium and reducing its bulk by muscle atrophy through denervation. We present our experience with ten cases of reconstruction for the dorsum of foot and ankle using the gracilis muscle free flap. Results were satisfactory without flap loss, skin loss and infection. The contour and aesthetic aspect of the foot was satisfactory. Gait analysis showed near normal gait without limitations from everyday activities. Normal footwear was tolerable in all the cases. The keys to consider in the reconstruction of the dorsum of foot and ankle are appropriate bulkiness, conforming to its contour and able to apply normal footwear. With minimal donor morbidity and satisfying results, the extended gracilis muscle should be considered as the first line for reconstruction of the ankle and dorsum of foot.

• Journal of Trauma and Injury
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• 제33권1호
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• pp.18-22
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• 2020

Purpose: Damage control laparotomy has contributed to improved survival rates for severe abdominal injuries. A large part of severe abdominal injury occurs with a concomitant pelvic bone fracture. The safety and effectiveness of internal fixation of pelvic bone fracture(s) has not been established. The aim of the present study was to evaluate infection risk in the pelvic surgical site in patients who underwent emergent abdominal surgery. Methods: This single-center retrospective observational study was based on data collected from a prospectively maintained registry between January 2015 and June 2019. Patients who underwent laparotomy and pelvic internal fixation were included. Individuals <18 and ≥80 years of age, those with no microbiological investigations, and those who underwent one-stage abdominal surgery were excluded. Comprehensive statistical comparative analysis was not performed due to the small number of enrolled patients. Results: A total of six patients met the inclusion criteria, and the most common injury mechanism was anterior-posterior compression (67%). The average duration of open abdomen was 98 hours (range, 44-98), and the time interval between abdominal closure and pelvic surgery was 98 hours. One patient (16.7%) died due to multi-organ dysfunction syndrome. Micro-organisms were identified in the abdominal surgical site in five patients (83%), with no micro-organisms in pelvic surgical sites. There was no unplanned implant removal. Conclusions: Internal fixation of pelvic bone fracture(s) could be performed in the state of open abdomen, and the advantages of early fixation may countervail the risks for cross contamination.