Fournier's gangrene is a fulminating gangrene of the male genitalia. It is associated with severe systemic toxic effect and a high motality rate, and it requires early diagnosis and intensive care with surgical intervention. We report a case of Fournier's gangrene in 33-year-old man, who showed marked swelling and necrosis of the scrotum, and extending cellulitis on the right flank and chest. With prompt excision of all the gangrenous scrotal skin and drainage incisions made on the flank and chest, the healing was successful.
Adult ; Cellulitis ; Drainage ; Early Diagnosis ; Fournier Gangrene* ; Gangrene ; Genitalia, Male ; Humans ; Critical Care ; Male ; Necrosis ; Scrotum ; Skin ; Thorax

The purpose of this study is to evaluate the results of primary repair and autogenous tendon augrnentation for acute rupture of anterior cruciate ligament. We primarily repaired 13 cases of acute ACL injury with autogenous tendon augmentation between Jul. 1988 and Jan. 1996. Among 13 cases, there were 2 isolated ACL injuries and 11 cases were combined with MCL injuries. All 13 cases were followed up over 1 year. An average follow up period was 4.1 years (1.1 - 8). All patients had open primary rnultiple suture repair and semitendinosus tendon (11 cases) or iliotibial band (2 cases) augmentation at average 3.6 days after the injury. In 11 cases, medial collateral ligarnent injuries were noted and these ruptured ligaments were supplemented with staple or vicryl suture. We evaluated the results with Lysholm Knee Score, KT-1000 arthrometer, postoperative ROM of knee, thigh muscle atrophy, extension lag, Lachman and pivot shift test. The clinical results were as follows 1. Lysholm Knee Score was mean 87.2 points; over 90 points: 5 cases, 80-8$ points: 5 cases, 70-79 points: 3 cases 2. Using the KT-1000 arthrometer, the average side to side difference wm 1.8nun in 201b (89N) and the compliance index was average 1.7mm. 3. Postoperative ROM of knee was nearly normal and there was no extensioe lag in any cases. But, we performed arthroscopic adhesiolysis in one case for limited motion of knee joint a ( postoperative 8 months. Thigh circumference was measured 0.95 cm difference than the healthy side at 10cm above upper pole of patella. 4. Lachman test was positive in 2 cases. 5. Pivot shift test was positive in 2 cases. Even if not many cases, we obtained relatively satisfactory results. So the pirimary repair with autogenous tendon auynentation was recornmandable procedure for acute rupture of ACL, especially combined with MCL injury.
Anterior Cruciate Ligament ; Compliance ; Follow-Up Studies ; Humans ; Knee ; Knee Joint ; Ligaments ; Methods ; Muscular Atrophy ; Patella ; Polyglactin 910 ; Rupture ; Sutures ; Tendons* ; Thigh

In shape and dimensions, the tibial plateaus are asymmetric with the larger medial tibial plateau and both have a posterior inclination with respect to the shaft of the tibia. Maximizing tibial coverage is an impotant consideration in total knee arthroplasty to provide stahility and load transfer and to improve long-term survival rate of the implants. Most tihial tray designs are symmetric, but several asymmetric designs are available. We evaluated the proximal tibial resection surface during total knee aithroplasty to delineate the tibial plateaus in korean. After tihial bone cut during 100 TKA procedures, the outline of tibial resection suiface was traced and rotational axis of true tibial component was marked intraoperatively. A line was drawn at the maximal anteroposterior (AP) diameter of lateral tibial condyle with parallel to rotational axis of component, and then a transverse axis was drawn at the midpoint of maximal AP diameter of 1ateral tibial condyle. Anteroposterior 10, 20, 30., 40% and midpoint from the media1 and lateral peripheries were calculated manually. The average AP medial 10, 20, 30 and 40% dimensions were 34.7, 43.8, 48.0 and 43.2mm, respectively. The average AP lateral 10, 20, 30 and 40% dimensions were 30.2, 38.4, 42.0 and 40.9mm, respectively. The ratio of medial/lateral AP dimensions 10, 20, 30 and 40% from periphery were 116.9, 114.7, 114.5 and 106.4%, respectively. From these data, we know the asymmetry of the proxirnal tibia1 plateaus in korean. We hope that rnore data will be ohtained in multicenter studies and it will help us to select tibia1 tray and to design the tibial component in korean. But, more accurate standard measures will he need to minimize an error of measurements.
Arthroplasty* ; Axis, Cervical Vertebra ; Hope ; Knee* ; Survival Rate ; Tibia

As upper-gastrointestinal endoscopy has been more widely used for the diagnosis and treatment of upper gastrointestinal diseases, some complications such as bleeding, perforation, arrhythmia, aspiration pneumonia, infection, and drug reaction of premedication were reported. Also a few case of salivary gland swelling complicated by endoscopy was described, but the precise mechanism of this benign complication is not well-known. The hypothesized mechanisms for salivary gland swelling are 1) air distension of blind branchial cleft remmants, 2) compression of its duct between the mylohyoid and hyoglossus muscles from pressure above, during a time of increased salivary flow from oral stimulation, 3) forward and downward dislocation of gland by the force that occurs when endoscope pushes the tongue, and 4) reaction to topical anesthesia less likely. Here we report 5 cases of salivary galnd swelling with a review of the literature, explaining possible mechanism of each case.
Anesthesia ; Arrhythmias, Cardiac ; Branchial Region ; Diagnosis ; Dislocations ; Endoscopes ; Endoscopy* ; Gastrointestinal Diseases ; Hemorrhage ; Muscles ; Pneumonia, Aspiration ; Premedication ; Salivary Glands* ; Tongue

A 44 year-old male without a specific past history demonstrated violaceous colored. angulated flat papules in a zosteriform arrangement along the medial aspect of left arm and upper anterior chest for 3 months. In addition, whitish patches with a lace-like pattern were seen on the buccal mucosa. The histopathologic findings were characteristic of lichen planus. The zosteriform lichen planus is a rare variant of lichen planus, Especially, it has been rarely observed in cases that developed without a previous history of herpes zoster or factors that lead to the Koebner phenoinenon In this context, it piqued our scientific curiousity enough to investigate it.
Adult ; Arm ; Herpes Zoster ; Humans ; Lichen Planus* ; Lichens* ; Male ; Mouth Mucosa ; Thorax

Various immunologic studies were performed for the investigation of humoral immunity in 30 patients with Behcet's syndrome who had been registered in Behcet Special Clinic of Severance Hospital: direct immunofluorescent staining, quantitation of serurn Ig, complement by immunoelectrophoresis and B-cell by EAC-rosette method. The results can be summerized as follows: 1. Direct immunofluorescent staining occurs in biopsies from patients with Behcets syndrome: 11 of the 30 patients(36. 7%). Among them, vascular fluorescene with C3 was noted in 10 of 11 patients (90. 9%), in addition of IgG, IgA, IgM, and fibrinogen on dermoepidermal junction or vessel. 2. The results of direct immunofluorescence staining showed different tendency according to biopsy sites and clinical types: 5 of 10(50%,) in the specimens from oral mucosa, 5 of 13(38.5%) from leg, 1 of 3(33.3%,) from genitalia, and 0 of 7(0%) from other sites: higher in complete and incomplete types than in suspected and possible types. 3. Immunofluorescent staining rates were statistically not significant according to sex, age and Lehner's classification. 4. Serum IgG, IgA, IgM, C3, C4 and B-cell were statistically not significant between DIF positive and negative groups. Therefore it is considered that vascular deposits of immune complexes and activation of complements by immune omplexes may be a role of pathogenetic mechanisms of Behcet's syndrorne.
Antigen-Antibody Complex ; B-Lymphocytes ; Behcet Syndrome* ; Biopsy ; Classification ; Complement System Proteins ; Fibrinogen ; Fluorescent Antibody Technique, Direct ; Genitalia ; Humans ; Immunity, Humoral* ; Immunoelectrophoresis ; Immunoglobulin A ; Immunoglobulin G ; Immunoglobulin M ; Leg ; Mouth Mucosa

No abstract available.
Hemiplegia ; Scabies*

Background: In Mason classification type II radial head fractures, compared to plate fixation, fixation with cannulated headless screws and absorbable pins has been reported to provide more favorable postoperative outcomes, including less postoperative limitation in range of motion. The fact that radial head fractures are less prone to weight-bearing during fracture union further supports the use of absorbable screws as a suitable alternative treatment option in radial head fractures. This study aimed to perform fixation through open reduction using bioabsorbable magnesium screws for Mason type II radial head fractures and to report radiographic and clinical results. Methods: Among patients who visited the orthopedic department from April 2017 to August 2021, 22 with surgical indications were selected for participation. Radiographic tests were conducted at 2 weeks, 4 weeks, 8 weeks, 12 weeks, 6 months, and over 1 year after surgery to confirm the degree of bone union, reduction loss, and degree of H 2 gas production. The Disabilities of the Arm, Shoulder and Hand (DASH) score, Mayo Elbow Performance Score (MEPS), hand grip power, and range of joint motion were measured at the 6-month follow-up to evaluate the clinical efficacy of the operation. Results: Bone union was confirmed in all 22 cases, and the mean time to union was 10.2 weeks. DASH score was 22.27 on average and no patients complained of significant discomfort after the surgery. The mean MEPS was 91.1. The hand grip power of the affected hand was similar to that of the unaffected hand, being 1.19% weaker on average. These differences reached statistical significance (p = 0.002). The range of elbow joint motion was measured: mean flexion, 146.1°; mean extension, 1.4°; mean pronation, 88.2°; and mean supination, 87.9°. Conclusions In treating Mason type II radial head fractures, the use of bioabsorbable screws made of magnesium showed satisfactory results in radiographic and clinical evaluations. Magnesium bioabsorbable screws can maintain sufficient stability at the fracture site and have the advantage of avoiding secondary operation for the removal of internal fixation devices.

The appendiceal mucocele is a rare disease and very difficult to get the diagnosis preoperatively because of the rartity of classical symptoms. With progress in diagnostic procedures such as colonofiberscopy, preoperative diagnosis of appendiceal mucocele has become possible. We experienced a case of appendiceal mucocele in 50 years old male who was admitted due to vague RLQ discomfort, and was diagnosed by colonofiberscopy and surgical specimen obtained by right hemicolectomy. So we present this case with a review of literatures.
Appendix ; Diagnosis ; Humans ; Male ; Middle Aged ; Mucocele* ; Rare Diseases

The authors retrospectively reviewed the high resolution computed tomographic scans of 19 patients who had hematogenous or lymphangitic metastatic lung lesions. In all patients, the histologic diagnosis for primary cancers and the radiographic manifestations of pulmonary metastasis were established. Certain characteristic findings of metastatic lung tumors on HRCT scans were evident: uneven thickening of bronchovascular bundles, multiple small nodules, thickening of interlobular septum, and the presence of polygonal lines. The nodules are more predominent in hematogenous metastasis. The prevalent site of nodules is cortical portion of lung.
Diagnosis ; Humans ; Lung ; Neoplasm Metastasis* ; Retrospective Studies