No abstract available.
Fournier Gangrene*

In transtrochanteric rotational osteotomy to treat osteonecrosis of the femoral head, the necrotic superior anterior femoral head is rotated anteriorly around the longitudinal neck axis so that the weight bearing force is transferred to the intact posterior surface. The ratio of transposed intact articular surface of the femoral head to the weight-bearing surface of the acetabulum on postoperative anteroposterior view of the hip roentgenograph is the most important indicator of the prognosis. During the period from December 1992 to June 1994, we treated 31 hips in 28 patients who were indicated for the anterior rotational osteotomy among the patients of osteoncrosis of the femoral head. Among the patients, male were 27 and female was one. Age distribution was from 13 to 62 years old and mean age was 44.3. According to the Ficat and Arlet classification, II A was most in number as 16 II B was 7 and III was 8. As their etiolgic factors, alcohol was most in number as 18, steroid was 3, idiopathic was 5 and trauma was 2. The mean rate of the intact area of the posterior part of the femoral head to the total articular surface on the preoperative lateral view of the hip roentgenograph was 41.8%. The mean ratio of transposed intact articular surface of the femoral head to the weight bearing surface of the acetabulum was 53.8% Fixation devices were screws or dynamic hip screw.
Acetabulum ; Age Distribution ; Classification ; Female ; Head* ; Hip ; Humans ; Male ; Neck ; Osteonecrosis* ; Osteotomy* ; Prognosis ; Weight-Bearing

The Measurement of CSF glucose and CSF glucose-to-blood glucose ratio is a very useful laboratory test for the differential diagnosis of meningitis. We have observed the change of blood glucose & CSF glucose-to-blood glucose ratio according to the time of blood sampling in 84 patients with aseptic meningitis who had been admitted to the department of pediatrics, Dong Kang hospital from May 1993 to June 1993. The results obtained were as follows: 1) The blood glucose level examined with blood sample drawn just before lumbar puncture and one just after lumbar puncture was 98.29+/-16.20mg/dl and 106.49+/-19.47mg/dl, respectively. 2) The blood glucose level examined with blood sample drawn just before lumbar puncture and one 30 min. after lumbar puncture was 96.47+/-21.52mg/dl and 117.00+/-22.12mg/dl, respectively. 3) The CSF glucose-to-blood glucose ratios examined with blood sample drawn just before lumbar puncture and one just after lumbar puncture was 67.70+/-12.40% and 62.83+/-12.62%, respectively. 4) The CSF glucose-to-blood glucose ratios examined with blood sample drawn just before lumbar puncture and one just after lumbar puncture was 70.10+/-21.77% and 56.35+/-13.75%, reskpectively. We concluded that a simultaneous blood glucose level should be taken just before lumbar puncture.
Blood Glucose ; Diagnosis, Differential ; Glucose* ; Humans ; Meningitis ; Meningitis, Aseptic* ; Pediatrics ; Spinal Puncture

Tuberculous spondylitis is not rare disease. Today the posterior instrumentation and posterior or posterolateral fusion concomitant with the anterior decompression and anterior interbody fusion have been used for the treatment of spinal tuberculosis. The authors experienced a case of tuberculous spondylitis complicated with descending aortic pseudoaneurysm. An aneurysm is defined as a localized dilatation of an artery that is at least one-half the size greater than is expected for that artery. Pseudoaneurysm occurring after previous operation, trauma, and infection. Erosion of the thoracic aorta with the development of an fistula in the presence of infection is an unusual and difficult problem to manage. We report a case and review related articles briefly.
Aneurysm ; Aneurysm, False* ; Aorta, Thoracic ; Arteries ; Decompression ; Dilatation ; Fistula ; Rare Diseases ; Spondylitis* ; Tuberculosis, Spinal

Although the management of fractures of the calcaneus still remains controversial, open reduction and internal fixation is gaining in popularity as the method of choice for the treatment of displaced intraarticular calcaneal fractures. However, open methods can make several complications such as neurovascular injury and infection. Thus we have performed the new technique of arthroscopic reduction and minimal internal fixation for displaced intraarticular calcaneal fractures in 5 cases. The results were evaluated between 12 and 16 months after surgery. A Bohler angle was restored to 25degrees-40degrees in all cases. Anatomical reduction of articular surface were obtained from 4 cases out of 5. No complications were found except 1 peroneal tendinitis. The clinical results by Creighton-Nebraska health foundation assessment for fractures of the calcaneus were 3 excellent, 1 good and 1 fair. Even though this was a few case and a short term follow-up study, the arthroscopic assisted management of displaced intraarticular calcaneal fracture induced a little complications and satisfactory results.
Calcaneus ; Follow-Up Studies ; Tendinopathy

We report a cace of 69-year-old man who developed massive pulmonary hemorrhage and subsuquent adult respiratory distress syndrome following intravenous urokinase for acute myocardial infarction. Pulmonary hemorrhage is a rare but a potentially life-threatening complication after thrombolytic therapy and should be considered in the differential diagnosis of pulmonary infiltrates of falling hemoglobin after thrombolytic therapy for acute myocardial infarction with no obvious site of bleeding.
Adult* ; Aged ; Diagnosis, Differential ; Hemorrhage* ; Humans ; Myocardial Infarction* ; Respiratory Distress Syndrome, Adult* ; Thrombolytic Therapy* ; Urokinase-Type Plasminogen Activator

A 28-year-old man presented with a 6.0 * 5.0 cm sized ulcer on the anterior chest and widespread copper-red colored maculopapular eruptions. There was no past or family history of syphilis sign or STS. He had been taken imposition of hands twice to treat chronic hepatitis about 4 months prior to presentation. Thereby, the ulcerative lesion on the anterior chest developed as a result of erosive trauma through contact with infected fingernails. The clinical features and serologic tests as well as biopsy findings were consistent with syphilis. Spirochetes were observed under the dark field examination of the anterior chest lesion. On Warthin-Starry staining, spirochetes were identified in the epidermal area of the papular lesion. We report a case of unusual transmission of syphilis.
Adult ; Biopsy ; Hand* ; Hepatitis, Chronic ; Humans ; Nails ; Serologic Tests ; Spirochaetales ; Syphilis* ; Thorax ; Ulcer

BACKGROUND: Paederus derriattis is a peculiar linear lesion caused by an insect belonging to genus Paederus, family Staptylinidae, order Coleoptera. The deliberate or accidental contact of crushed coelomic fluid of th insect, on the skin causes acute lesions due to a t.oxin(pederin) being released. OBJECTIVE: The study was nade in order to investigate an epidemic status of the peculiar der matitis and its causative agent of factor prevailing in the midwest area of Kyungpuk province. METHODS: We performed field approaches on 633 cases(M: 303, F: 330) including cases enrolled in a local clinic, teamiring up with a local skin clinician over the 3-month period of August November in 1994. RESULTS: 1. The captive insect causing the present dermatits, was identified as Paederus fuscipes(PF). The epidemic might be attributeid to the climatic conditions with higher temperature than usual during the period of July-eary September in the past year by 3-4degrees C as well as a lower relative humidity. The active temperature zone for PF was presumed to be about 15.5+1.2degrees C to 28.9+1.0degrees C 2. There was the highest p;evalence of 412 cases(65.1%) in early September, followed by mid September, late August, early October and mid August in a small number of cases in decreasing order. The cases were not found after mid October. 3. All age groups were evealy represented. The sex ratio was 1: 1.1 with little difference. The majority of cases lived in Kiriich on city(80.3%), with a lesser outbreak in the neighboring coun ties and Kumi city. 4. The preferred site was the mainly exposed area such as face, neck and extremities. The number of lesion was single(60%) and multiple(40%). The lesion showed a common linear con figuration and acute irritant contact dermatitis consistent with the histologic finding. CONCLUSION: The unusual wiather conditions and poor environmental hygiene help to develop an ecosystem breakdown, which, in turn, sometimes influences the innocuous insects life to be harm ful being on humans, as like outbreak of PF dermatitis.
Beetles ; Dermatitis* ; Dermatitis, Contact ; Ecosystem ; Epidemiologic Studies* ; Extremities ; Gyeongsangbuk-do ; Humans ; Humidity ; Hygiene ; Insects ; Neck ; Sex Ratio ; Skin

Nevus sebaceus is a common hamartoma that has a variety of appendage tumors. We report a case of nevus sebaceus with multiple appendage tumors on the scalp of a 43-year-old male. The exudative inflamed patches were admixed with darkly pigmented small nodules which had developed secondarily within a 4.0 × 1.5cm lesion 2 years previously. Histologically, on serial sectioning, there were various types of basal cell carcinoma, syringocystadenoma papilliferum, tubular apocrine adenoma and sebaceous adenoma. Some parts of a biopsy specimen, showed a tumor of the follicular infundibulum-like epidermal changes. There were also calcium depositions in the stroma and apocrine tumors, There was no relapse at 1-year follow-up after surgical treatment.
Adenoma ; Adult ; Biopsy ; Calcium ; Carcinoma, Basal Cell ; Follow-Up Studies ; Hamartoma ; Humans ; Male ; Nevus* ; Recurrence ; Scalp

Periventricular-intraventricular hemorrhage (PV-IVH)is one of the most important neurologic lesion of the low birth weight infants. Serial neurosonographic exeaminations were performed in 113 low birth weight infants who were admitted to the neonatal intensive care unit of Presbyterian Medical Center from November 1, 1990to July 31, 1991. The results were summarized as follows: 1) The incidence of PV-IVH in the study was 54% 2) According to Papile's grading system of PV-IVH, grade I was 32.8%, grade II was 45.9%, grade IIIwas 11.5% and grade IV was 9.8%. 3) The onset of PV-IVH was within the first 7 days of life in 82%. 4) Poor activity, apnea, bradycardia and hypotension were statistically significant clinical findings associated with PV-IVH(P<0.05). 5) The risk factors associated with PV-IVH were gestational age, birth weight, hyaling membrane disease, patent ductus arteriosus and artifical ventilation. 6) The mortality of PV-IVH was 0% for grade I, 10.7% for grade II,42.9% for grade III and 83.3% for gradeIV.
Apnea ; Birth Weight ; Bradycardia ; Diagnosis* ; Ductus Arteriosus, Patent ; Gestational Age ; Hemorrhage* ; Humans ; Hypotension ; Incidence ; Infant* ; Infant, Low Birth Weight* ; Infant, Newborn ; Intensive Care, Neonatal ; Membranes ; Mortality ; Protestantism ; Risk Factors ; Ventilation