BACKGROUND: Urinary retention is the most common complication after perianal surgery. The authors tried to evaluate the influence of the types and duration of the operation and the types of anesthesia on the incidence of urinary retention. METHODS: The medical and anesthetic records of 106 patients were reviewed retrospectively. They got perianal surgerys after recieving one of the regional blocks; 0.5% hyperbaric bupivacaine 5~8 mg intrathecally, 0.5% hyperbaric tetracaine 5~8 mg intrathecally, or 2% lidocaine 300 mg with epinephrine 5 g/ml caudally. The incidences of urinary retention were compared with each other by Chi-square test and Student t-test, according to the above mentioned points. RESULTS: Fifty percent of these patients underwent urinary catheterization. The incidence of urinary retention after hemorrhoidectomy (56.6%) was higher than that of other anorectal procedures (p<0.05, Chi-square test). The longer operating time was associated with urinary retention (p<0.05, Student t-test). The influence of local anesthetics (bupivacaine, tetracaine, and lidocaine) was absent (p>0.05, Chi-square test), but the difference between spinal and caudal anesthesia was slightly significant (p<0.05, Chi-square test), i.e. the incidence of urinary retention after caudal anesthesia was low. CONCLUSIONS: Short duration of operation, less traumatized perianal surgery, and caudal anesthesia are thought to lead to the lower incidence of urinary retention.
Anesthesia ; Anesthesia, Caudal ; Anesthesia, Conduction ; Anesthetics, Local ; Bupivacaine ; Epinephrine ; Hemorrhoidectomy ; Humans ; Incidence ; Lidocaine ; Retrospective Studies ; Tetracaine ; Urinary Catheterization ; Urinary Catheters ; Urinary Retention*

Bowens disease is generally regarded as a premalignant dermatosis. If untreated, 3% to 5% of patients may develop squamous cell carcinoma. However, sebaciou carcinoma arising from Bowens disease is very rare. We presented a case of quarnous cell carcinoma and sebaceous circ s disease in a 68 year-old male. He had multiple bowenoid skin lesi nsties. A bean-sized nodule as developed on the bowenoid lesion of the he had a large yellow crust.ed exudative tumor on the Rt. thigh. We took a biopsy specimen of these three discrete lesions. The nu lipid stain of frozen section revealed Bowens disease, squarnous concllnoma arising from Bowen on the trunk and extremi Rt. lower abdomen. Almost of routine histology and carcinoma, and sebaceous carcinoma, respectively.
Abdomen ; Aged ; Biopsy ; Bowen's Disease ; Carcinoma, Squamous Cell* ; Frozen Sections ; Humans ; Male ; Skin ; Skin Diseases ; Thigh

No abstract available.
Humans

In pili torti, the affected Eair shaft is flattened and twisted through 180 degrees on its own axis. The involved hairs are dry, thin, brittle, and break off easily. Congenital pili torti may occur as an isolated phenomenon or may occur in association with other abnormalities. Acquired pili torti is usually associated with some sort of scarring process in the scalp itself. We present a case of congnital pili torti without any other abnormalities in a 14 year-old female. The pedigree of her fariiily was consistent with the inheritance of congenital pili torti as an autosomal dominant trait.
Adolescent ; Axis, Cervical Vertebra ; Cicatrix ; Female ; Hair ; Humans ; Pedigree ; Scalp ; Wills

BACKGROUND: Herpes zoster(HZ), caused by reactivation of latent varicella-zoster virus, is manifested by dermatomal distribution of skin rashes, acute pain and post-herpetic neuralgia by pathologic involvement of the sensory ganglia. Low-energy laser(LEL) deliver a small amount of energy without elevation of the tissue temperature. LEL is reported to have various biologic effects such as anti-inflammatory, analgesic, regenerative, antiallergic, immunocorrective, and antibacterial effects. OBJECTIVE: We attempted to evaluate the therapeutic effect of LEL on an acute phase of HZ. METHODS: A total of 60 patients with acute HZ were enrolled in the study. The control group(30 patients) received medications including analgesics, antihistamine, and topical care without LEL irradiation. The experimental group(30 patients) were irradiated with LEL daily for 7 days in addition to the same kinds of medications for the control group. The efficacy of LEL irradiation for HZ was assessed by analyzing changes in skin rashes, pain scores, and postherpetic neuralgia.
Acute Pain ; Analgesics ; Exanthema ; Ganglia, Sensory ; Herpes Zoster* ; Herpesvirus 3, Human ; Humans ; Neuralgia ; Neuralgia, Postherpetic

Biofeedback is the treatment of choice for functional defecation disorders such as idiopathic chronic constipation and neurogenic fecal incontinence. The pre-existing biofeedback systems have many disadvantages. The aims of current project are, first, to develop the biofeedback system into the application software in the Windows environment, and, second, to assess the possibility of clinical usage for patients with functional defecation disorders. The hardware and software of the BASCO (Biofeedback Anal Sphincter Control) system were based on the signal measurement and signal processing of anal sphincter EMG (Electromyography). BASCO system was applied to 5 normal healthy controls and 20 patients with functional defecation disorders. Patients group was categorized as constipation group (N1=15) and incontinence group (N2=5). With use of current system, EMG-based biofeedback therapy was performed, and the outcome was analysed. Anal EMG signal data was processed by the software, and displayed in the monitor of personal computer. The software of EMG-display and database management were adequately operated. In N1 group, a paradoxical elevation or equalized activity of anal EMG pattern was shown in the simulated defecation. In N2 group, low electrical activity was shown. These findings were used for the EMG-based biofeedback therapy as a pilot study. The clinical symptoms were improved in 12 of N1 group and 3 of N2 group in the period of 3.7 (range, 1~12) months follow-up. In Conclusion, newly-developed BASCO system was adequately operated in the volunteer and patients groups. The multi-tasking and multi-processing functions were adequately shown in the real time. Current results could be used for clinical appraisal. Specifically, this system could be used for the practical application of biofeedback therapy in the patients with chronic constipation or fecal incontinence.
Anal Canal* ; Biofeedback, Psychology* ; Constipation ; Defecation* ; Fecal Incontinence ; Follow-Up Studies ; Humans ; Microcomputers ; Pilot Projects ; Volunteers

Necrotizing fasciitis, first described by Wilson in 1952, is one of the most dramatic infectious diseases which develops at the level of superficial fascia and involves the overlying dermis. Clinical diagnosis is often initially confused with cellulitis, and delay in the diagnosis and treatment is associated with high mortality in the range from 30% to 70%. Early diagnosis and prompt excision of all devitalized tissue are critical because any remaining necrotic tissue will continue the rapidly progressive infectious process. We, herein, report a 64-year-old man who was presented with a typical clinical course of necrotizing fasciitis.
Cellulitis ; Communicable Diseases ; Dermis ; Diagnosis ; Early Diagnosis ; Fasciitis, Necrotizing* ; Humans ; Middle Aged ; Mortality ; Subcutaneous Tissue

Purpose: To report the surgical skills needed, and the clinical results of, minimally invasive hip surgery with dynamic hip screws and the comparison with the classical technique in stable pertrochanteric fractures of the femur. Materials and Methods: Thirty-two patients with pertrochanteric fractures of the femur who were treated with dynamic compression hip screws between April 1999 and March 2004, and were evaluated retrospectively, and were followed up for more than 12 months. 16 cases were treated with a classical dynamic hip screw technique and 16 cases with a minimally invasive technique in random order. The mean age was 73.2 years, and there were 11 males and 21 females. The operative times, total hemovac bleeding loss, functional scores, and average hemoglobin decrease ratios were evaluated. The clinical assessments were performed with the Harris Hip Score (HSS) and bony union was evaluated with serial follow-up plain radiographs. Results: The average operative time was 63.9 minutes with the classical technique and 42.5 minutes with the minimally invasive technique. The total average hemovac blood loss was 640 cc with the classical technique and 143 cc with the minimally invasive technique. Clinically, the HHS was an average of 85.9 and 89.2 in groups 1 and 2, respectively, by the last follow-up and there were no statistically significant differences between the two groups (P <0.05) The hemoglobin decrease ratio was the same in both groups and there was no nonunion. Conclusion: Minimally invasive dynamic hip screw insertion was useful in stable pertrochanteric fractures, because it decreased blood loss and operative times; and there were no changes in fracture healing and functional outcomes.
Female ; Femur ; Follow-Up Studies ; Fracture Healing ; Hemorrhage ; Hip* ; Humans ; Male ; Operative Time ; Retrospective Studies ; Surgical Procedures, Minimally Invasive

The significance of the posterior cruciate ligament (PCL) in the stability of the knee and the necessity for surgical repair of its tears are still controversial. The purpose of this study is to present the short term results of surgical repair and Kennedy LAD augmentation for 15 cases with PCL injury. In 14 patients (15 knees), the torn PCL was repaired with pullout suture technique and Kennedy LAD augmentation was done from june 1993 to june 1994. The follow-up period ranged from 12 months to 25 months (average, 18months). The main causes of injuries were traffic accidents in 12. Thirteen of the patients were men and one was a woman, ranging in age from 17 to 52 years(average, 35 years). 10 knees were acute injury and repaired at average 9 days after injury. There were 11 cases that had combined injuries(4 ACL injuries, 4 meniscus injuries, 3 MCL injuries etc). In eight knees, the tear was in mid substance area and in five it was near femoral attach site and in two it was near tibial attach site. Postoperative results were evaluated by roentgenographic evaluation of posterior sagging and Lysholm knee score. 11 knee were stable but 4 knees were unstable posteriorly during postoperative follow-up period. 3 chronic injuried knees were included in 4 posteriorly unstable knees. There are 7 combined knee injuries in 11 stable knees and no combined injuries in unstable knees and average Lysholm knee score was 89.7 in stable knees and 90 in unstable knees and there was no significant difference between two groups. On the based of this study, surgical repair with pollout suture technique and augmentation with Kennedy LAD in acute PCL injury is a one of the good method for preventing posterior sagging but more longer follow-up period and more cases must be needed to accept this method.
Accidents, Traffic ; Female ; Follow-Up Studies ; Humans ; Knee ; Knee Injuries ; Lysholm Knee Score ; Male ; Methods ; Posterior Cruciate Ligament ; Suture Techniques ; Tears

The refractive effects of incision parameters on surgically induced astigmatism in sutureless cataract surgery were studied retrospectively by automatic keratometeric evaluation. 215 eyes undergoing phacoemulsification and posterior chamber intraocular lens implantation were divided into five groups according to the incision length, direction and location : group 1 (14 eyes), 3.5mm superior scleral incision : group 2 937 eyes), 3.2mm temporal clear corneal incision : group 3 (24 eyes), 3.2mm temporal scleral incison : group 4 (24 eyes), 5.5mm superior scleral incision : group 5 (116 eyes), 5.5mm temporal scleral incision. All eyes were examined by keratometry preoperatively as well as at 1 days, at 1 and 2 weeks and at 1 and 2 months after surgery. Cravys vector analysis was performed to calculate the surgically induced astigmatism and keratometric readings were converted to polar values to estimate the mean postoperative keratometric astigmatism. After two postoperative months, mean induced atigmatism was -0.37+/-0.36D in Group 1, 0.27+/-0.44D in Group 2, 0+/-0.33D in Group 3, -0.74+/-0.46D in Group 4 and 0.22+/-0.63D in Group 5. There fore we constructed our own nomogram for managing astigmatism at cataract surgery.
Astigmatism* ; Cataract* ; Lens Implantation, Intraocular ; Nomograms ; Phacoemulsification ; Reading ; Retrospective Studies