• Title/Summary/Keyword: Focal infection

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Three Phase Bone Scintigraphy in Active and Inactive Osteomyelitis (활동성 및 비활동성골수염에서의 삼상골신티그라피)

  • Yang, Woo-Jin;Chung, Soo-Kyo;Ha, Hyun-Kwon;Bahk, Yong-Whee
    • The Korean Journal of Nuclear Medicine
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    • v.22 no.2
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    • pp.209-213
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    • 1988
  • To Appreciate the value of bone scintigraphy in determination of the bony infection, we performed three phase bone scintigraphy in 34 cases of osteomyelitis of extremities prospectively. They were clinically inactive in 11 and active in 23 cases. We confirmed the active osteomyelitis by operation or aspiration within one week after scintigraphy. Perfusion, blood pool and delayed images were analyzed respectively and compared with the plain roentgenograms. All 23 active lesions showed diffusely increased perfusion in affected limbs. The areas of the increased activities on blood pool images were larger than or similar to those on delayed images in 17 cases (73.9%) with active osteomyelitis and smaller in 6 cases (26.1%). 5 of the latter 6 cases showed definite soft tissue activities on blood pool images. In inactive cases bone scintigrams were completely normal in 4 cases. Two of those were normal on plain films and remaining two showed mild focal bony sclerosis. Among 7 inactive lesions, perfusion was normal in 2 cases, diffusely increased in 4 cases and diffusely decreased in 1 case. 6 of these 7 cases showed increased activities both on blood pool and delayed images and the areas of increased activities on blood pool images didn't exceed those on delayed images. Bony sclerosis was noted on plain films in those 7 inactive lesions and the extent of the sclerosis correlated well to delayed images. Large blood pool activity was characteristics of active osteomyelitis. Normal three phase bone scintigram may indicate the time to terminate the treatment, but increased activity on perfusion and blood pool scans is not absolute indication of active lesion if the extent of the lesion on the blood pool image is smaller than that on delayed image and if no difinite soft tissue activity is noted on perfusion and blood pool images in clinically inactive patient.

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Pathological studies on exudative epidermitis in experimentally infected pigs I. Macroscopical and histopathological observations (실험적 돼지 삼출성 표피염에 관한 병리학적 연구 I. 육안적 및 병리조직학적 관찰)

  • Oh, Kyu-shil;Lee, Cha-soo
    • Korean Journal of Veterinary Research
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    • v.34 no.4
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    • pp.787-799
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    • 1994
  • To elucidate morphologic lesion of porcine exudative epidermitis which is occurred sporadically in Korea, Staphylococcus hyicus subsp. hyicus isolated from the naturally affected pigs was inoculated to suckling pigs. The infected piglets were observed grossly and histopathologically. Although affected piglets were taking acute, subacute, or chronic course, some piglets suffered from chronic disease showed poor prognosis and marked growth depression. Affected peglets had erythematous skin on the face, ear, and abdomen and these localized lesions appear as brownish spots of exudative epidermitis and fromed crust in the early stage. But, after this stage, the skin were covered by viscous greasy exudate and formed blackish brown crust and appeared fissures and hypertrophy. Grossly, there has been hemorrhage with the removal of crust-like materials of epidermis and edematous subcutis. The superficial lymph nodes were edematous and swollen or congested and hemorrhagic. Some piglets had swollen ureters, cysts in the renal cortex, or polyarthritis. A few cases had mild edematous swelling of kidney, intestinal catarrh and congestion of brain. Microscopically, skin lesions had detachment of keralinized layer and parakeratosis of epidermis, hydropic degeneration of epidermal cell, and retrogressive degeneration of hair root sheath. Dermis had edema, and infiltration of neutrophils and mononuclear cells. As the disease was proceeded, there was marked perivasculitis with lots of mononuclear inflammatory cells. More chronic lesions formed granuloma-like bodies(nodules) due to more mononuclear, perivascular inflammatory cell infiltration and proliferation of fibroblast. Lots of plasma cells and eosinophils were also present in dermis. Epidermis was hyperplastic by proliferation of basal cells stratum germinativum and epidermal pegs often extended into the dermis. In secondary infection, lots of neutrophils could be seen in epidermis and derms. Kidney had neutrophilic infiltration, necrotic and cystic glomeruli, and dilation of renal tubules and ureters. Purulent arthritis was sometimes observed in joints. Three days old mice administrated Staphylococcus hyicus subsp hyicus subcutaneously before had focal congestion and hemorrhage, necrosis, and subcutaneous edema of the skin. This observation was also seen in the study of mice administrated exfoliatin toxin of Staphylococcus which evoked human staphylococcal scalded skin syndrome.

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Surgical Treatment of Tracheal Stenosis (기관 협착증의 외과적 치료)

  • 최준영;장인석;김종우;김병균;이정은;김성호;이상호
    • Journal of Chest Surgery
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    • v.33 no.7
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    • pp.565-569
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    • 2000
  • Background; Post-intubation injury is known to be the most common cause of tracheal stenosis. Treatment strategy for tracheal stenosis varies accoring to the extent of pathologic lesion. Focal mucosal lesion can be treated with laser photoablation, but full thickness tracheal lesion should be treated with resection and anastomosis. Material and Method; From Aptil 1998 to May 1999, twelve patients suffering from tracheal stenosis as a complication of endotracheal intubation were managed by resection and end-to-end anastomosis in the Department of Thoracic and Cardiovascular Surgery, Gyeongsang National University Hospital. Result; There was no operative mortality. Five temporary vocal cord paralysis and one wound infection occurred as early complications. During 18 months of follow-up, re-stenosis was not found. Conclusion; Tracheal resection and anastomosis can be considered as an excellent surgical treatment for tracheal stenosis which developed as a complication of endotracheal intubation.

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Improved Detection of Helicobacter pylori Infection and Premalignant Gastric Mucosa Using Conventional White Light Source Gastroscopy

  • Matrakool, Likit;Tongtawee, Taweesak;Bartpho, Theeraya;Dechsukhum, Chavaboon;Loyd, Ryan A;Kaewpitoon, Soraya J;Kaewpitoon, Natthawut
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.2099-2103
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    • 2016
  • Background: The gold standard diagnosis of H. pylori related gastritis is evidence of bacteria on histopathological examination of gastric mucosa. Our aim was to study the correlation between gastric mucosal morphology and histopathological severity of H. pylori related gastritis. Materials and Methods: Division was made on morphological features into:Type 1, showing regular arrangement of red dots; Type 2, showing cleft-like appearance; Type 3, with a mosaic appearance; and Type 4, having a mosaic appearance with focal or diffuse hyperemia. Results: Types 1 and 2 gastric mucosal morphologies were statistically significant in predicting an H. pylori negative status (137/145, p<0.01), while Types 3 and 4 were significant a positive status (139/155, p<0.01). The sensitivity, specificity, positive and negative predictive values of Type 3 and 4 morphologies for predicting H. pylori positive were 94.6%, 89.5%, 89.7% and 94.5%, respectively, with a good correlation with inflammation grading (p<0.01). Conclusions: Our study suggests that gastric mucosal morphology can be reliably identified using conventional white light source gastroscopy with good correlation between findings and inflammation grading.

Liver transplantation in a child with acute liver failure resulting from drug rash with eosinophilia and systemic symptoms syndrome

  • Song, Seung Min;Cho, Min Sung;Oh, Seak Hee;Kim, Kyung Mo;Park, Young Seo;Kim, Dae Yeon;Lee, Sung Gyu
    • Clinical and Experimental Pediatrics
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    • v.56 no.5
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    • pp.224-226
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    • 2013
  • Drug rash with eosinophilia and systemic symptoms (DRESS) syndrome is characterized by a severe idiosyncratic reaction including rash and fever, often with associated hepatitis, arthralgias, lymph node enlargement, or hematologic abnormalities. The mortality rate is approximately 10%, primarily owing to liver failure with massive or multiple disseminated focal necrosis. Here, we report a case of a 14-year-old girl treated with vancomycin because of a wound infection by methicillin-resistant Staphylococcus aureus, who presented with non-specific symptoms, which progressed to acute liver failure, displaying the hallmarks of DRESS syndrome. With the presence of aggravated hepatic encephalopathy and azotemia, the patient was refractory to medical treatments, she received a living-donor liver transplantation, and a cure was achieved without any sign of recurrence. Vancomycin can be a cause of DRESS syndrome. A high index of suspicion and rapid diagnosis are necessary not to miss this potentially lethal disease.

A Case of Group A Streptococcal Pneumonia with Empyema and Pericardial Effusion (폐농양과 심막삼출이 동반된 A군 연구균에 의한 폐렴 1례)

  • Chun, Yoon Hong;Lee, Soo Yong;Choi, Sang Lim;Jeong, Dae Chul;Chung, Seung Yeon;Kang, Jin Han
    • Pediatric Infection and Vaccine
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    • v.11 no.2
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    • pp.202-207
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    • 2004
  • Group A streptococcus, also known as Streptococcus pyogenes, is a common bacterial pathogens of the upper respiratory tract and skin infections in children, but this organism is a less common cause of pneumonia, pericarditis. However, pneumonia that is caused by Streptococcus pyogenes, may be rapidly progressive course with developing severe consequences. It may be focal but often is bilateral and diffuse involvement of lung. Empyema is commonly developed, and pleurocentesis often yields thin, watery fluid that continues to flow out when a chest tube is inserted. Antimicrobial resistance to the ${\beta}$-lactam antibiotics has not been reported against group A streptococci, whereas increasing resistance to the macrolides seems to be directly related to the consumption of specific antimicrobial agent use in the community. Clindamycin resistance is uncommon but does occur. We experienced one case of group A streptoccoccal pneumonia with empyema and pericardial effusion, and treated successfully with amoxicillin-clavulanate, clindamycin and roxithromycin.

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Middle Lobe Syndrome (중엽증후군)

  • 이용훈;김병철
    • Journal of Chest Surgery
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    • v.29 no.6
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    • pp.621-625
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    • 1996
  • "Middle lobe syndrome" which was described y Graham and associates at first is always caused by ex- ternal bronchial compression by Iymph nodes. Although the patients may not present any symptom, the most common presenting symptoms were cough, dyspnea, fever, hemoptysis, and chest pain. Diagnostic procedures includ chest X-ray bronchoscopy, brochography, chest CT, and the principal finding is the contracted middle lobe which is usually airless. We experienced fifteen cases of middle lobe syndrome from April 1990 to May 1995. Eleven patients were treated surgically. The surgical candidates for middle lobe syndrome are suspicious malignancy, fixed bronchiectasis, bronchostenosis, intractable to medical treatment, recurrent infection. Operations were right middle lobectomy (8), right middle and lower bilobectomy (2), right upper and middle bilobectomy (1). Postoperative histological findings were tuberculosis in six, chronic inflammation in three, malignancy in one, and focal hemorrhage in one. There were two cases of postoperat ve complications which were postoperative atelectasis and hepatopathy.patopathy.

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A Case of Inflammatory Pseudotumor at Tongue Base (설 기저부에 발생한 염증성 가성종양 1예)

  • Lee, Hyun-Sub;Huh, Se-Hyung;Jin, Sugn-Min;Lee, Sang-Hyuk
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.22 no.1
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    • pp.56-59
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    • 2011
  • Inflammatory pseudotumor is characterized by the presence of a mass that may mimic malignancy and is composed of spindle cells mixed with variable amounts of extracellular collagen, lymphocytes, and plasma cells It is benign tumor commonly involves lung and orbit and rarely that occurs in the head and neck The cause and pathogenesis of inflammatory pseudotumor still remain controversial. Some bacterial infection or chronic irritation may have prompted some speculation that an initially reactive process can change into an overt neoplastic disease. It tends to affect children and young adults than old ages. We present a case of inflammatory pseudotumor involving the tongue base, in a 73-year-old patient with repeated oral bleeding that aggravated over a few days. Clinical examination showed angiomatous polyp like findings in oropharynx that easy bleeding tendency. CT images showed well defined soft tissue mass with focal enhancement. After surgery, tumor was finally diagnosed inflammatory pseudotumor by histopathologic examinations showed plasma cells and inflammatory cells in variable fibrotic tissues.

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Acupuncture Therapy and Herbal Medicine Accelerating Temporal Space Abscess after Tooth Extraction: A Case Report

  • Lee, Sangip;Lee, Deok-Won;Ryu, Dong-Mok
    • Journal of Korean Dental Science
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    • v.7 no.2
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    • pp.94-98
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    • 2014
  • Numerous oral and maxillofacial surgeons have found facial space infections after tooth extraction. Most of these infections can be managed easily, but some of them could be life-threatening. Among the facial infections, temporal space infections are rare. Most temporal space infections could be observed as secondary to maxillary third molar infections, maxillary sinusitis, and maxillary sinus fractures. Note, however, that there are insufficient studies on temporal space abscess due to mandibular second molars, especially with acupuncture. A 74-year-old female came to our hospital with severe trismus and facial swelling on the right temporal, buccal, posterior auricular, and cervical regions. The patient had undergone extraction of tooth #47 secondary to dental caries by a general dentist about a month ago. After the dental procedure, the patient had been treated with acupuncture therapy around the right temporomandibular joint area at the oriental medicine clinic. We performed emergency incision and drainage under general anesthesia and started antibiotic treatment with IV ampicillin/sulbactam 3 g every 24 hours and vancomycin 1 g every 24 hours for 5 days. The patient's symptoms subsided and ultimately disappeared. Temporal space abscess after mandibular molar extraction is quite rare. In this case, the spreading mechanism against gravity is considered to be acupuncture therapy.

Treatment Result of Foot Amputation Stratified by Level of Amputation (절단 위치에 따른 족부 절단술의 치료 결과)

  • Kim, Ji Hoon;Ko, Hyeong Tak;Suh, Jin Soo
    • Journal of Korean Foot and Ankle Society
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    • v.19 no.1
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    • pp.18-22
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    • 2015
  • Purpose: The purpose of this study is to evaluate the incidence and cause of reamputation with respect to the location of foot amputation. Materials and Methods: Eighty-six patients who received amputations below the ankle level from March 2002 to September 2012 with at least 1 year follow-up were enrolled in this study. We stratified the site of the initial amputation from first to fifth ray and into either the phalanx or metatarsal bone, and investigated the cause of reamputation. Results: The reamputation rate below the ankle level was 53.5%. It was highest (62.1%) in patients with first ray amputations without statistical significance. Rays were divided into two columns, first to third rays as the medial column and others as the lateral column, and reamputation was performed in 61.2% of patients with medial column amputation. Comparing the results between phalanx and metatarsal amputations, reamputation was performed in 62.1% of patients with metatarsal bone amputation. The rate of reamputation was statistically significant in both the medial column and metatarsal amputations. The most common reamputation site, in accordance to the initial site of amputation, was the adjacent ray (57.4%), which was without statistical significance. Moreover, the most common cause of reamputation was osteomyelitis and focal infection in all rays. Conclusion: This study showed that reamputation after amputation below the ankle level was relatively common with highest rate in medial column and metatarsal amputations. Hence, surgeons should be aware of the risk of reamputation and put more preventive effort during medial column and metatarsal amputations.