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

OBJECTIVES: The aim of this study was to know differences of characteristics between presenile and senile patients who were consulted to the department of psychiatry during medical-surgical admission. METHODS: The demographic and clinical data obtained from the medical records of psychiatric consultation in the presenile inpatients with age 50 to 64 years(N=162) and those of the senile inpatients with age over 65 years(N=171) were reviewed and compared. RESULTS: 1) The most common chief complaints for psychiatric consultation in presenile patients were somatic symptoms, anxiety and sleep disturbance in order, while cognitive decline, clouded consciousness and depressed mood were most common in senile patients with statistical significance. 2) The most frequent psychiatric diagnoses after consultation in presenile patients were delirium, mood disorder and substance use disorder in order, while delirium, mood disorder and major neurocognitive disorder were most frequent in senile patients with statistical significance. 3) There were no significant difference in numbers of physical illnesses, while numbers of therapeutic drugs for them were more in senile patients. CONCLUSIONS: Our study found significant differences between presenile and senile patients on psychiatric symptoms and diagnoses in geropsychiatric consultation. Therefore, more subdivided age-specific approach seems to be needed for the geropsychiatric consultation activities.
Anxiety ; Consciousness ; Delirium ; Diagnosis ; Humans ; Inpatients* ; Medical Records ; Mood Disorders ; Substance-Related Disorders

OBJECTIVES: The aims of this study were to know the prevalence of cognitive disorders in patients with thyroid cancer, and identify related variables to them. METHODS: Subjects were consisted of fourty-two patients with thyroid cancer, who were admitted for radioiodine ablative therapy at 6-12 months after total thyroidectomy. The data were obtained from interviews about history and assessments of depression and cognitive function(Korean Version of the Montreal Cognitive Assessment, MoCA-K). RESULTS: 1) Among subjects, those with below 22 of total score of the MoCA-K were twenty-one(50.0%). 2) Upon age, education, Pre-radioiodine therapy thyroid stimulating hormone(TSH), there were statistically significant difference between subgroup with above 23 of the total MoCA-K score and those below 22. 3) The total scores of the MoCA-K in subjects had significant correlation with age, education, comorbidity, Pre-radioiodine therapy TSH, total score of the HDRS-17. CONCLUSIONS: Cognitive disorders were more prevalent among patients with thyroid cancer before radioiodine therapy. Therefore, further study should be needed to clarify the mechanism for the cognitive disorders in thyroid cancer. Furthermore, physicians should pay attention to the cognitive function and prepare preventative measures for cognitive disorder during management of thyroid cancer.
Carcinoma, Papillary* ; Comorbidity ; Depression ; Education ; Humans ; Prevalence ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroidectomy ; Thyrotropin

In order to assess the efficiency of Percoll gradient centrifugation(PGC) as a method of sperm selection, we have examined morphological characteristics of spermatozoa from 40 teratozoospermic patients attending the Infertility Clinic of Inchon Gil Gerneral Hospital. Patients were divided into three groups according to percentage normal morphology in the fresh sample : group A(n=5), < 5% normal morphology : group B(n=21), 5~14% normal morphology : and group C(n=14), > 14% normal morphology. Morphology slides were perpared using Diff-Quik staining techniques and evaulated by Kruger strict criteria, under oil immersion at a magnification of X 1000, specific defects, head, neck and tail were assesed individualy. The results were as follows. 1. Following PGC, sperm samples with enhanced morphology were recovered for all groups. 2. For group A, PGC did not select a sample with significantly improved morphological characteristics. 3. Usually, sperm defects affected by PGC was head and neck. No significant difference was found for tail abnormality. In conclusion, Percoll gradient centrifugation is an efficient sperm preparation technique when the semen sample exhibits teratozoospermia, especially head or neck abnormality. However, in sample with < 5% normal form or tail abnormality, There is not significant improvement following PGC.
Centrifugation* ; Equidae ; Head ; Humans* ; Immersion ; Incheon ; Infertility ; Neck ; Semen ; Spermatozoa*

No abstract available.
Thanatophoric Dysplasia*

Burning mouth syndrome is characterized by intra-oral burning sensation without any organic abnormalities. This syndrome is associated with various etiological factors such as neuropathy, malnutrition, menopause and depression. Several medications have been tried for the treatment. Those are analgesics, hormones, anticonvulsants and antidepressants. However, optimal effective pharmacologic treatment remains still unknown. The purpose of this case study is to report the clinical effectiveness of gabapentin in the treatment of burning mouth syndrome in postmenopausal women with comorbid depression. We report two menopausal women. Antidepressants were effective for improving depressive symptoms, but it had no effects on intra-oral burning sensation. Gabapentin reduced intra-oral burning sensation effectively for all two patients. One patient reported 55% reduction(a decrease from 9 to 4 on VAS), the other patient reported 35% reduction(from 8 to 5) of the intra-oral burning sensation during 16 weeks. The minimal effective daily dose of gabapentin was 300mg. This study suggests that gabapentin might be a useful, effective therapeutic option for treating burning mouth syndrome in postmenopausal women with comorbid depression. Further prospective clinical studies are needed to investigate the effectiveness of gabapentin in patients with burning mouth syndrome.
Analgesics ; Anticonvulsants ; Antidepressive Agents ; Burning Mouth Syndrome* ; Burns ; Depression* ; Female ; Humans ; Malnutrition ; Menopause ; Sensation

The orbital blowout fracture has been increasingly noticed due to trauma and traffic accidents. The diagnostic confirmation is early established by CT scan, but indication for surgical treatment, the technique for repair, and timing of repair are still controversial. The main symptoms of orbital fracture include diplopia, enophthalmos and hypesthesia in distributions of the infraorbital nerve. These are usually accompained by other symptoms such as emphysema of the eyelids, ptosis, epistaxis and ocular injury. Among these diplopia and enophthalmos are considered as main surgical indications. Especially operation is performed when the contractibility of extraocular muscle(EOM) is changed due to incarceration of EOM and persistent diplopia at straight forward gaze or downward gaze. Many theories for sugical repiar timing are insisted but at present the accepted timing for operation is posttraumatic 1-2 weeks. To prevent the fibrosis and atrophy of extraocular muscle from the incarceration of EoM due to orbital fracture is the indication of surgery. To estimate the optimal time to perform the operation, we checked the EOM contractivilty by electromyography before and after artificial muscle incareceration in the rabbit. The results were as follows. The differences in RMS(root mean square) and MRV(mean rectified voltage) were not shown before or after the artivicial incarceration of extraocular muscle until the 5th day of the surgery. But the RMS and MRV measurements performed on the 7th day decreased significantly and these decreases were sustained. According to the results of this experiment. if the incarceration of the extraocular muscle due to the orbital fracture is diagnosed, relieving the incarceration by surgery before the 7th day can prevent the change of EOM contractibility. It will provide significant benefit, in maintaining the normal functioin of the extraocualr muscle.
Accidents, Traffic ; Atrophy ; Diplopia ; Electromyography ; Emphysema ; Enophthalmos ; Epistaxis ; Eyelids ; Fibrosis ; Hypesthesia ; Orbit ; Orbital Fractures ; Tomography, X-Ray Computed

PURPOSE: To evaluate the ultrasonographic (US) or computer tomography (CT) findings of surgically proven epidermal cysts in the trunk, and to compare the echogenicity of cysts with internal contents. MATERIALS AND METHODS: Forty-five patients were retrospectively evaluated. US and CT findings of epidermal cysts were assessed in regard to location, size, shape, number, echogenicity, posterior sound enhancement, internal density, septa, mural nodule and calcification, perilesional infiltration, contrast enhancement, and internal contents. RESULTS: All 45 patients (M: F=29: 16; US in 26, CT in 19) had only one cyst, and they were located in the buttocks (n=19), back (n=13), inguinal (n=4), posterior neck (n=3), perineum (n=2), abdominal wall (n=2), presternal (n=1), and axilla (n=1). Of 26 patients who underwent US, there were 8 cases of homogeneously hypoechoic mass (30.8%), 8 of inhomogeneously hypoechoic mass (30.8%), 7 of homogeneously hypoechoic mass with internal hypoechoic lines and echogenic spots (26.9%) and 3 of homogeneously hypoechoic mass with internal echogenic spots (11.5%). Posterior sound enhancement was noted in 21 patients (80.8%). Of 19 patients who underwent CT, there were 14 cases of simple cyst (73.7%) and 5 of abscess-like lesion (26.3%). Overlying skin thickening (n=13), contrast enhancement of cystic wall (n=11), perilesional infiltration (n=7), and internal septa (n=6) were demonstrated. The internal contents of the cysts were keratinous (n=27, 60.0%) or greasy (n=15, 33.3%) material. There was no statistical significance between the echogenicity of the cysts and the internal contents (p >0.2). CONCLUSION: Epidermal cysts showed homogeneous or inhomogeneous hypoechoic mass with posterior sound enhancement on US. There was no relationship between the echogenicity of the cysts and the internal contents. In the case of ruptured cyst, an abscess-like lesion with wall enhancement and perilesional infiltration was noted on CT scan.
Abdominal Wall ; Axilla ; Buttocks ; Epidermal Cyst* ; Humans ; Neck ; Perineum ; Retrospective Studies ; Skin ; Tomography, X-Ray Computed

Purpose: The purpose of this systematic review was to elucidate the optimal age for patients undergoing total knee arthroplasty (TKA), to optimize the balance between the benefits and risks by analyzing patient-reported outcome measurements (PROM), revision rate, and mortality according to age. Materials and methods: A rigorous and systematic approach was used and each of the selected studies was evaluated for methodological quality. Data were extracted according to the following: study design, patients enrolled, patient age at the time of surgery, follow-up period, PROM, revision rate, and mortality. Results: Thirty-nine articles were included in the final analysis. The results were inconsistent in the PROM analysis, but there was consensus that PROM were good in patients in their 70s . In the revision rate analysis, there was consensus that the revision rate tends to increase in TKA in younger patients, but no significant difference was observed in patients > 70 years of age. In the mortality analysis, there was consensus that the mortality was not significantly different in patients < 80 years of age, but tended to increase with age. Conclusion This systematic review shows that the PROM were good when TKA was performed in patients between 70 and 80 years of age; the best PROM could be achieved around 70 years of age, and no significant difference in the revision or mortality rates was observed between 70 and 80 years of age; however, mortality tended to increase with age. Therefore, the early 70s could be recommended as an optimal age to undergo TKA.

Purpose: The purpose of this systematic review was to elucidate the optimal age for patients undergoing total knee arthroplasty (TKA), to optimize the balance between the benefits and risks by analyzing patient-reported outcome measurements (PROM), revision rate, and mortality according to age. Materials and methods: A rigorous and systematic approach was used and each of the selected studies was evaluated for methodological quality. Data were extracted according to the following: study design, patients enrolled, patient age at the time of surgery, follow-up period, PROM, revision rate, and mortality. Results: Thirty-nine articles were included in the final analysis. The results were inconsistent in the PROM analysis, but there was consensus that PROM were good in patients in their 70s . In the revision rate analysis, there was consensus that the revision rate tends to increase in TKA in younger patients, but no significant difference was observed in patients > 70 years of age. In the mortality analysis, there was consensus that the mortality was not significantly different in patients < 80 years of age, but tended to increase with age. Conclusion This systematic review shows that the PROM were good when TKA was performed in patients between 70 and 80 years of age; the best PROM could be achieved around 70 years of age, and no significant difference in the revision or mortality rates was observed between 70 and 80 years of age; however, mortality tended to increase with age. Therefore, the early 70s could be recommended as an optimal age to undergo TKA.