We report two cases of cellulitis on the saphenous venectomy scar which developed after a coronary artery bypass graft(CABG). A 68-year-old male and a 62-year-old female developed acute cellulitis in the saphenous vein donor extremity after CABG. The repeated bacterial cultures were negative in both cases. However, onychomycosis was confirmed in one patient. The intervals between CABG and the initial bout of cellulitis in the male and female patient were 10 and 22 months, respectively. Although the exact pathogenesis remains obscure, factors such as direct bacterial infection, hypersensitivity to streptococcal exotoxins, a local compromise of lymphatic and venous drainage, and fungal infection might have contributed to the development of cellulitis in these patients.
Aged ; Bacterial Infections ; Cellulitis* ; Cicatrix* ; Coronary Artery Bypass* ; Coronary Vessels* ; Drainage ; Exotoxins ; Extremities ; Female ; Humans ; Hypersensitivity ; Male ; Middle Aged ; Onychomycosis ; Saphenous Vein ; Tissue Donors

Diabetes mellitus is known to be associated with a specific cardiomyopathy. This is evident from the clinical-pathological work and the epidemiologic data. An investigation was made in this study to determine whether diabetic cardiomyopathy in rats is associated with an alteration of biochemical characteristics of cardiac contractile proteins. Rats were made diabetic with intravenous injection of streptozotocin and hearts removed 8 weeks later for the isolation of myofibrils. The basal ATPase activity of myofibrils from diabetic hearts was significantly lower than that of the controls, suggesting the presence of some subtle structural and conformational changes in diabetic myofibrils. The activating effect of Mg ions on the myofibrillar actomyosin system of rat heart muscle was also demonstrated. Sodium dodecylsulfate gel electrophoresis showed the presence of myosin heavy chain, light chain 1 and 2, actin and troponin but failed to reveal differences in the patterns of these contractile proteins of light subunits between diabetics and controls. The deficiency in utilization of energy rich phosphates by the myofibrillar protein may be one of of the main mechanisms of cardiodepression observed in diabetic hearts. The cardiac myofibrillar ATPase activity may be one of useful measurements in evaluating pathophysiological states of cardiac contractile proteins.
Actins ; Actomyosin ; Adenosine Triphosphatases* ; Animals ; Cardiomyopathies ; Contractile Proteins ; Diabetes Mellitus ; Diabetic Cardiomyopathies ; Electrophoresis ; Heart ; Injections, Intravenous ; Ions ; Myocardium ; Myofibrils ; Myosin Heavy Chains ; Phosphates ; Rats* ; Sodium ; Streptozocin ; Troponin

We report a case of myelodysplastic syndrome (MDS) with unique histopathological findings in which numerous infiltrated neutrophils exhibited nuclear segmentation anomalies. In comparison with well-described neutrophilic dermatoses of myelodysplastic syndrome such as Sweets syndrome and pyoderma gangrenosum, this case took a rapid and aggressive clinical course. We suggest that a nuclear segmentation anomaly, pseudo Pelger-Hiiet anomaly, is likely to reflect acute transformation of MDS and can be a poor prognostic marker.
Myelodysplastic Syndromes ; Neutrophils* ; Pyoderma Gangrenosum ; Skin Diseases ; Sweet Syndrome

BACKGROUND: The incidence of Cutaneous malignant tumors has increased recently and they have varied in their developing patterns according to social and environmental influences. However, we have little clinical data about the cutaneous malignant tumors in the Chonnam provinee. OBJECTIVE: Our purpose was to analyze the clinical characteristics of cutaneous malignant tumors observed in the Chonnam province and to compare them with the data previously reported in Korea. METHOD: We clinically analyzed 427 cases of cutaneous malignant tumors during a 10 year period betwecn January 1987 and Oetober 1996, at the Department of Dermatology, Chonnam Univemity Hospital in Kwangju. RESULTS: 1. The average armual incidence of cutaneous malignant tumors among the total number of outpatients was 1.00+/- 0.25%. The incidence tended to increase with time from 0.90+/-0.29% in the first 5 year-period to 1.15+/-0.09% in the late 5 year-period. The increasing rate was most pronmient in basal cell carcinoma. 2. The most common tumor in the 427 patients with malignant tumor was basal cell carcinoma (52.5%), followed by squamous cell carcinoma (19.9%), malignant melanoma (13.3%), metastatic carcinoma (3.7%), malignant lymphoma (2.3%). 3. The mean age of onset was 60.7+/-16.0 years old (male; 59.6+/-15.0, female; 61.9+/-17.1) in the in the group as a whole; 63.9 in BCC, 63.3 in SCC and 55.8 in malignant melanoma. The ratio of men to women was 1.14:l. 4. The most common site of a11 malignant tumors was the head and neck (64.6%), where 89.3% of BCC, 58.8% of SCC, and 15.8% of malignant melanoma developed. The next common site was the lower exlremities and feet (15.7%) followed by the trunk (7,7%), and upper extremities and hands (7.3%).
Age of Onset ; Carcinoma, Basal Cell ; Carcinoma, Squamous Cell ; Dermatology ; Female ; Foot ; Gwangju ; Hand ; Head ; Humans ; Incidence ; Jeollanam-do* ; Korea ; Lymphoma ; Male ; Melanoma ; Neck ; Outpatients ; Upper Extremity

PURPOSE: The distal chevron osteotomy has gained popularity for the mild to moderate hallux valgus, but necessity of fixation is controversy. No fixation of distal chevron osteotomy cause instability, but fixation has problem which has pin site infection and irritability, extension of operation time, discomfort of rehabilitation. So, the author was going to analyse and compare with and without in the fixation of distal chevron osteotomy. MATERIALS AND METHODS: Between 2004 and 2005, a total 18 patients (20 feet) following with and without in fixation of distal chevron osteotomies. The fixation group (A) was performed for the treatment of 10 patients (10 feet) and no fixation group (B) was done to 8 patients (10 feet). RESULTS: On group A, the mean first MTP (metatarsophalangeal) angle corrected 17 degrees pre-operatively to average 29 degrees (range; 20-37 degrees) and the mean first IM (intermetatarsal) angle corrected 10 degrees pre-operatively to average 15 degrees (range; 9-18 degrees). On Group B, the mean first MTP angle corrected 16 degrees pre-operatively to average 29 degrees (range; 18-33 degrees) and the mean first IM angle corrected 7 degrees pre-operatively to average 13 degrees (range; 9-16 degrees) (P>0.05). Clinical results, based on AOFAS score showed an improvement in the overall results. CONCLUSIONS: Comparing the clinical and radiographic results of the distal chevron osteotomies no difference in with and without fixation of distal chevron osteotomies.
Hallux Valgus* ; Hallux* ; Humans ; Osteotomy* ; Rehabilitation

PURPOSE: To evaluate the clinical results of operative treatment of the intra-articular calcaneal fracture with injectable calcium sulfate (MIIG(TM)). MATERIALS AND METHODS: Between March 2004 and October 2006, a total 19 intra-articular calcaneal fracture (16 patients) with a large bony defect that underwent operative treatment with plate fixation and injectable calcium sulfate (MIIG(TM)) with minimum follow-up of one year following. The mean age at time of surgery was 44.7 years (23 to 54). All of the cases were type 2 and 3 on the basis of Sanders classification. The lateral L shaped approach was used in all cases. Full weight bearing on the affected extremity was regained at an average 10 weeks postoperatively. RESULTS: The mean B?hler angle was improved from 2 degrees (-18.5~12.5 degrees) preoperatively to 23.8 degrees (12~37.5 degrees) and the angle at last follow-up was 22.5 degrees (11.5~37.5 degrees), showing about 0.3 degree decline compared to postoperative B?hler angle. Only two case of whitish leakage of graft material but other complication were none. CONCLUSION: MIIG(TM) augumentation of displaced intra-articular calcaneal fracture with large bone defect seems to bo useful method for initial stabilized and plate fixation.
Calcaneus ; Calcium Sulfate* ; Calcium* ; Classification ; Extremities ; Follow-Up Studies ; Intra-Articular Fractures ; Transplants ; Weight-Bearing

PURPOSE: The purposes of the current study were to assess the early results of cementless hip arthroplasty (HA) for femoral neck fractures in elderly patients with severe osteoporosis and to compare the clinical outcomes between those who underwent total HA (THA) or bipolar hemiarthroplasty (BHA). MATERIALS AND METHODS: From April 2011 to May 2012, we performed 87 cementless HAs for displaced femoral neck fractures in elderly patients (> or =65 years) with severe osteoporosis. Among them, we studied 70 hips that were able to be followed-up for >24 months. Of these, 34 underwent THA and 36 underwent BHA. Clinical results were evaluated using the Harris hip score (HHS), Koval classification, and radiographs. RESULTS: Only one instance of femoral stem loosening was observed. Additionally, no dislocations were observed and no revision surgeries were required. The mean changes in the functional items of the HHS scores were 2.8 and 5.2 for those who underwent THA and BHA, respectively (P<0.05). According to the Koval classification used for the ambulatory status analysis, the mean perioperative change in the grade was 0.8 (0-4), with no significant differences noted between the THA and BHA groups. CONCLUSION: The early results of cementless HA for femur neck fractures in elderly patients with osteoporosis were satisfactory, and THA was found to have a functional advantage over BHA.
Aged* ; Arthroplasty* ; Butylated Hydroxyanisole ; Classification ; Dislocations ; Femoral Neck Fractures* ; Hemiarthroplasty ; Hip ; Humans ; Osteoporosis*

Skin and soft tissue infection (SSTI) is common and important infectious disease. This work represents an update to 2012 Korean guideline for SSTI. The present guideline was developed by the adaptation method. This clinical guideline provides recommendations for the diagnosis and management of SSTI, including impetigo/ecthyma, purulent skin and soft tissue infection, erysipelas and cellulitis, necrotizing fasciitis, pyomyositis, clostridial myonecrosis, and human/animal bite. This guideline targets community-acquired skin and soft tissue infection occurring among adult patients aged 16 years and older. Diabetic foot infection, surgery-related infection, and infections in immunocompromised patients were not included in this guideline.
Adult ; Cellulitis ; Communicable Diseases ; Diabetic Foot ; Diagnosis ; Erysipelas ; Fasciitis ; Fasciitis, Necrotizing ; Humans ; Immunocompromised Host ; Impetigo ; Methods ; Pyomyositis ; Skin* ; Soft Tissue Infections*

Escherichia coli (E. coli) is a clinically important causative organism that can lead to urinary tract infections. Quinolone antibiotics are among the first-line treatments for urinary tract infections. However, the frequency of resistance to quinolone in E. coli has been increasing. Therefore, new antimicrobial agents that can be used for treatment in lieu of quinolone antibiotics are needed. In this study, thirty-six compounds with higher scores in a virtual screening based on the three-dimensional structure of E. coli DNA gyrase were selected for in vitro antimicrobial activity testing. An in vitro test confirmed the antimicrobial activity of 4-[(1-methyl-6-nitroquinolin-1-ium-4-yl)amino]-N-[4-[(1-methylpyridin-1-ium-4-yl)amino]phenyl]benzamide (ZINC18057104) against E. coli among the 36 compounds. The minimum inhibitory concentration (MIC) of ZINC18057104 against E. coli ATCC® 25922™ was 2 μg/ml, and the MIC₅₀ and MIC₉₀ for the 72 quinolone-resistant E. coli clinical isolates were 4 and 64 μg/ml, respectively. ZINC18057104, which has a quinoline structure which is similar to the quinolone antibiotics, is predicted to exhibit antimicrobial activity in quinolone-resistant E. coli because it has different molecular interactions with the DNA gyrase than that of existing quinolone antibiotics.
Anti-Bacterial Agents ; Anti-Infective Agents ; DNA Gyrase* ; DNA* ; Drug Discovery ; Escherichia coli ; In Vitro Techniques ; Mass Screening ; Microbial Sensitivity Tests ; Urinary Tract Infections

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