No abstract available.
Thyroid Gland* ; Thyroid Nodule*

Diabetic foot is one of the complications of diabetes mellitus, accompanied by infection, ulcer, deformity, and neuropathic arthropathy. The prevalence of diabetic foot is approximately 10% to 20% in adult diabetic patients over 30 years. Patients with diabetic foot show decreased life quality due to long-term treatment and hospital admission for various complications. Therefore, it is important to understand the etiology of diabetic foot and to prevent the accompanying complications.Current Concepts: Multiple complications of diabetic foot such as ulcers, infections, and deformities are derived from neuropathy (sensory, motor, and autonomic nerves) and angiopathy. Careful physical and radiologic examinations and laboratory evaluations are necessary to diagnose diabetic foot. Dressings, surgical decompressions, antibiotics, and vascular interventions are helpful for the treatment of ulcers in diabetic foot. Maintaining proper blood glucose levels and medication help control the neuropathies. Furthermore, patients should be educated on careful foot care to prevent complications.Discussion and Conclusion: Diabetic foot and its accompanying complications are difficult to treat and decrease patients’ quality of life. To prevent complications of diabetic foot, management of blood glucose, patient education on self-foot care, screening of high-risk factors, and cooperation of various medical specialists are needed.

Diabetic foot is one of the complications of diabetes mellitus, accompanied by infection, ulcer, deformity, and neuropathic arthropathy. The prevalence of diabetic foot is approximately 10% to 20% in adult diabetic patients over 30 years. Patients with diabetic foot show decreased life quality due to long-term treatment and hospital admission for various complications. Therefore, it is important to understand the etiology of diabetic foot and to prevent the accompanying complications.Current Concepts: Multiple complications of diabetic foot such as ulcers, infections, and deformities are derived from neuropathy (sensory, motor, and autonomic nerves) and angiopathy. Careful physical and radiologic examinations and laboratory evaluations are necessary to diagnose diabetic foot. Dressings, surgical decompressions, antibiotics, and vascular interventions are helpful for the treatment of ulcers in diabetic foot. Maintaining proper blood glucose levels and medication help control the neuropathies. Furthermore, patients should be educated on careful foot care to prevent complications.Discussion and Conclusion: Diabetic foot and its accompanying complications are difficult to treat and decrease patients’ quality of life. To prevent complications of diabetic foot, management of blood glucose, patient education on self-foot care, screening of high-risk factors, and cooperation of various medical specialists are needed.

PURPOSE: Bacillus Calmette-Guerin (BCG) is the most effective intravesical agent for patients with superficial bladder cancer, but the long-term efficacy of BCG has not been established. We report our long-term experience of intravesical BCG therapy in the recurrence and progression for superficial bladder cancer. PATIENTS AND METHODS: Between 1985 and 1993. high risk patients with superficial bladder cancer were received complete TURB plus intravesical BCG (n=77). 120mg Tice-Chicago strain BCG was administered weekly for 6 weeks and then monthly for 3 months. Patients were considered treatment failure if either urinary cytology or biopsy results were positive for tumor on every 3 to 6 months followup examination. All patients reported have had a minimum 2-year followup, with the mean of 63 months. RESULTS: The 1st course of BCG was successful in 47 (6696) of 71 patients treated for prophylaxis and 3 (50%) of 6 treated for carcinoma in situ. Subsequent progression of disease occurred in 6 patients (8%) and cystectomy was performed in 2 patients (3%). The response rate for the total patients population treated with the 1st course was 65% (50 of 77). Of 27 patients who failed the 1st treatment course 21 patients were given the 2nd BCG treatment course. Of the 2nd BCG course, subsequent progression of disease occurred in 3 patients (14%), and cystectomy was performed in 2 patients (9%). Thirteen (68%) had complete response and 5 (26%) had new tumors, who had rendered free of disease after TURB plus intravesical therapy (mitomycin and/ or BCG). Although serious BCG complications (hepatitis, miliary Tbc, sepsis) were observed in 2 patients, side-effects were self-limiting and well controlled in the majority of patients (fever, bladder irritability, and hematuria). CONCLUSIONS: Intravesical BCG therapy seems to be effective to prevent recurrence and progression of superficial bladder cancer with long-term follow-up. However, we must note the possibility of fatal generalized complications in patients with grossly trauma of lower urinary tract.
Bacillus* ; Biopsy ; Carcinoma in Situ ; Cystectomy ; Follow-Up Studies* ; Humans ; Mycobacterium bovis ; Recurrence ; Treatment Failure ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Urinary Tract

Congenital constricting band of the trunk is a rare malformation with a wide spectrum of associated congenital anomalies. A 3-year-old boy with a congenital constricting band around the waist and anterior thigh and clubfoot deformity is reported. Laboratory test and chest and abdominal X-ray examination were within normal limits and unremarkable. Histopathologic examination revealed compact fibrocollagenous bundles in deep dermis. The compact fibrocollagenous bundles are parallel to the skin surface and have thin wavy nuclei. We think these bundles caused annular constriction on the trunk. We follow up the patient regularly without specific treatment because the constricting band caused no functional impairment and hypertrophic scar had developed at the biopsy site.
Biopsy ; Child, Preschool ; Cicatrix, Hypertrophic ; Clubfoot ; Congenital Abnormalities ; Constriction ; Dermis ; Follow-Up Studies ; Humans ; Male ; Skin ; Thigh ; Thorax

In patients with diabetic foot, ulceration and amputation are the most serious consequences and can lead to morbidity and disability. Peripheral arterial sclerosis, peripheral neuropathy, and foot deformities are major causes of foot problems. Foot deformities, following autonomic and motor neuropathy, lead to development of over-pressured focal lesions causing the diabetic foot to be easily injured within the shoe while walking. Wound healing in these patients can be difficult due to impaired phagocytic activity, malnutrition, and ischemia. Correction of deformity or shoe modification to relieve the pressure of over-pressured points is necessary for ulcer management. Application of selective dressings that allow a moist environment following complete debridement of the necrotic tissue is mandatory. In the case of a large soft tissue defect, performance of a wound coverage procedure by either a distant flap operation or a skin graft is necessary. Patients with a Charcot joint should be stabilized and consolidated into a plantigrade foot. The bony prominence of a Charcot foot can be corrected by a bumpectomy in order to prevent ulceration. The most effective management of the diabetic foot is ulcer prevention: controlling blood sugar levels and neuropathic pain, smoking cessation, stretching exercises, frequent examination of the foot, and appropriate education regarding footwear.
Amputation ; Arthropathy, Neurogenic ; Bandages ; Blood Glucose ; Congenital Abnormalities ; Debridement ; Diabetic Foot* ; Education ; Exercise ; Foot ; Foot Deformities ; Humans ; Ischemia ; Malnutrition ; Neuralgia ; Peripheral Nervous System Diseases ; Sclerosis ; Shoes ; Skin ; Smoking Cessation ; Transplants ; Ulcer* ; Walking ; Wound Healing ; Wounds and Injuries

End-stage ankle arthritis is a debilitating condition that causes functional limitations and consequently a poor quality of life. Total ankle replacement arthroplasty is a good alternative to arthrodesis for preserving the ankle’s range of motion. However, many complications can occur in patients with rheumatoid arthritis and with poor soft tissue and bone conditions. A 61-year-old female experienced spacer subluxation after surgery, which was not reduced by medial soft tissue release and spacer change. Buttress plating was found to be a good treatment option to prevent spacer subluxation and can be considered in patients with rheumatoid arthritis with bone erosion and soft tissue damage.

Purpose: Postoperative exercise for acute Achilles tendon rupture is important for a patient’s return to daily life and sports. On the other hand, the protocol requires considerable effort to educate patients and continuous checking. This study evaluated the outcome of a new simple and delayed rehabilitation protocol after Achilles tendon rupture repair. Materials and Methods: From July 2014 to November 2020, one hundred eighty-three patients were operated on by one surgeon. The exercise protocol was classified into two methods. One group (immediate protocol, control group) started immediate full weight bearing with a 20° plantar flexion range of motion from two days postoperatively. Ankle dorsiflexion was restricted to 0°. The other group (delayed protocol, case group) started full weight bearing with a controlled ankle motion boot from two weeks postoperatively. No range of motion exercise was allowed until six weeks postoperatively. Age, sex, body mass index, ankle range of motion, muscle power, time to return to previous physical activity, functional score, and complication rate were evaluated. The results of the two groups were compared using a Mann–Whitney test. Statistical significance was set as p<0.05. Results: The range of motion, double heel rising, and one-leg standing were achieved faster in the control group (p<0.05). However, single-heel rising, repeated single-heel rising, return to previous activity (work, run, and sport), and functional scores showed no statistical difference (p>0.05). Conclusion Simple and delayed postoperative rehabilitation of acute Achilles tendon rupture without active range of motion exercises showed satisfactory functional results and a low complication rate.

Purpose: Leg elevation is known as an effective method for reducing leg swelling, and it has been routinely used in medical practice. However, the effect of swelling reduction in relation to the degree of elevation height is not known. This study evaluated the swelling of the leg after acute ankle fracture operations at two different elevation heights and the elevated leg heights were compared. Materials and Methods: A total of 66 patients with postoperative acute ankle fractures were classified into two groups depending on the presence of different leg elevation heights: high-elevated (HE, case) and low-elevated groups (LE, control). We checked leg swelling, pain, subjective satisfaction for the elevation device, and the American Orthopedic Foot and Ankle Society (AOFAS) score, and we retrospectively compared them between both the groups. Results: Leg swelling and pain were reduced in both groups. However, they did not show any significant differences between both the groups (p>0.05). Nineteen patients in the HE group replied with uncomfortable, while no patients in LE group did so. The AOFAS score at 1 year postoperatively did not show any significant differences between both the groups (p=0.46). Conclusion High elevation of the leg after ankle fractures did not show a significant difference from low elevation in regard to leg swelling, pain, and function. Furthermore, high leg elevation resulted in discomfort during the postoperative period. Thus, low elevation with a pillow is enough for acute ankle fracture patients with little discomfort and satisfactory swelling reduction.

BACKGROUND: There have been few clinical studies of halo nevi. OBJECTIVE: The purpose of this study was aimed at evaluating the clinical and histopathologic features of halo nevi and correlation between halo nevi and vitiligo. METHODS: The medical records of 40 patients with halo nevi and biopsy specimens of 30 patients with halo nevi were reviewed. RESULTS AND CONCLUSION: 1.The ratio of male to female patients was 1:1.5. 2.The mean age of the onset was 20.1 years (male : 11.5, female : 25.9). 3.Multiple halo nevi were present in 32.5%(male : 25%, female : 37.5%). 4.The areas in which the lesions developed were head and neck(39.1%), back(32.8%), anterior chest(12.5%), abdomen(10.9%), groin(3.1%), and lower extremity(1.6%) in descending order. 5.The mean duration of each color in central nevus was as follows: black(2.7 years), pink(3.5 years), gray(4.9 years) 6.The most common pathology of the central nevus was intradermal(80%). 7.The halo nevi associated with vitiligo were 21 cases(52.5%) out of 40 patients. Among them, the cases with non-segmental vitiligo were 13(61.9%), the cases with segmental vitiligo were 8(38.1%). 8.Out of the 21 cases with halo nevi associated with vitiligo, the cases with halo nevi prior to vitiligo were 4(19.1%), concurrent onset 12(57.1%) and the cases with halo nevi after vitiligo were 5(23.8%).
Biopsy ; Female ; Head ; Humans ; Male ; Medical Records ; Nevus ; Nevus, Halo* ; Pathology ; Vitiligo