Purpura fulminans (gangrenosa) is a rare clinical syndrome characterized by sudden appearance of rapidly progressive symmetrical subcutaneous ecchymosis durimg the convalescent stage of various infectious disease. A 4 year-old. boy has developed multiple skin defects with necrosis on extrernities and gangrenous changes on the left foot following a meningococcemia. B-K amputation on left leg and. free skin graft for multiple skin defect on extremities were, carried out.
Amputation ; Child, Preschool ; Communicable Diseases ; Ecchymosis ; Extremities ; Foot ; Humans ; Leg ; Male ; Necrosis ; Purpura Fulminans* ; Purpura* ; Skin ; Transplants

BACKGROUND: The purpose of this study was to evaluate the usefulness and safety of the anterosuperior deltoid splitting approach for fixation of displaced proximal humeral fractures by analyzing the surgical outcomes. METHODS: Twenty-three patients who could be followed-up for at least 8 months after the treatment of displaced proximal humeral fractures through the anterosuperior deltoid splitting approach were enrolled. We evaluated the reduction of the fractures and surgery-related complications at the last follow-up using X-ray results and clinical outcomes comprising the University of California at Los Angeles (UCLA) scoring system and the Korean Shoulder Society (KSS) score. RESULTS: At the last follow-up of patients treated using the anterosuperior deltoid splitting approach for internal fixation of proximal humeral fractures, we found 22 cases (95.6%) of bone union, a mean UCLA score of 28.3 (range, 15 to 34) and a mean KSS score of 82.1 (range, 67 to 95). Various surgery-related complications were noted; a case of varus malunion after fracture displacement, a case of nonunion, a case of delayed union, two cases of impingement, and a case of partial axillary nerve injury, which recovered completely through the follow-up. CONCLUSIONS: Plate fixation using the anterosuperior deltoid splitting approach could be another reliable option for treating displaced proximal humeral fractures.
California ; Follow-Up Studies ; Humans ; Humerus ; Shoulder ; Shoulder Fractures*

Although the results of foldable intraocular lens are generally excellent, there are several complications. After cataract surgery with silicone lens, the patients with vitreoretinal surgery using silicone oil have not only visual acuity decrease, but also visual abberations such as halos and rainbow patterns. To report a newly defined complication, we studied the silicone lens-silicone oil interaction. The nonimplanted ilicone, acryl and PMMA lens, ten cases each, had been incubated in silicon oil at 36C for 9 months. After removal from the oil, each lens was examined and photograp hed by scanning electron microscopy every week. Appearance of lens surface and degree of adherence of the silicone oil to each IOL`s optic were estimated. Oily residue on the PMMA and acryl lens was removed easily and shown clear surface. In case of silicone lens, presence of distinct film or coating of oil was shown on the surface of both the optic and haptic component of IOL`s. They could not be removed with mechanical pressure with injected balanced saline solution and the oily residue remained strongly adherent to the optic surface. After 9 weeks, gelly-like adherence was appe ared on the silicone lens surface. As a result, the use of silicone IOL`s in patients with current vitreoretinal disease or those who are at high risk for future vitreoretinal disease that may require silicone oil as part of the therapy should be reconsidered.
Cataract ; Humans ; Lenses, Intraocular ; Microscopy, Electron, Scanning ; Polymethyl Methacrylate ; Silicone Oils* ; Sodium Chloride ; Visual Acuity ; Vitreoretinal Surgery

No abstract available.
Humans ; Technetium Tc 99m Disofenin* ; Ultrasonography*

This study was conducted to investigate the effect of two-year course of food and nutrition on improving nutrition knowledge, dietary attitudes and food habits of junior college female students by questionnaires. The subjects were 108 college female students enrolled in the department of food and nutrition in Gyeonggi area. The results were as follows: There were no significant changes in the weights and BMI (Body Mass Index) after 2-yr course of food and nutrition. Nutrition knowledge (14.7 vs 16.3, p < 0.001) and dietary attitude (34.3 vs 35.8, p < 0.01) increased significantly after 2-yr course. However, no significant changes in food habit were observed. Among nutrition knowledge, the scores of functions (4.5 vs 5.2, p < 0.001) and understanding (6.7 vs 7.4, p < 0.01) of nutrients were significantly increased. The recognition of nutrition knowledge increased significantly (83.1 vs 95.7, p < 0.001). Among food habit, dietary habit (13.2 vs 12.5, p < 0.01) and health related habit (15.6 vs 14.6, p < 0.001) were significantly lowered after 2-yr course. The change in dietary attitudes showed significantly positive correlation with food habit changes (p < 0.05). These results showed that 2-yr course of Food and Nutrition had improved the nutrition knowledge and dietary attitudes. Therefore, providing the more systematic and appropriate nutrition education to students during their study period will be improved dietary attitudes and food habits.
Female ; Food Habits ; Humans ; Surveys and Questionnaires ; Weights and Measures

No abstract available.
Extremities* ; Osteogenesis* ; Ultrasonography*

BACKGROUND: There are many reports about the correlation between cardiovascular disorders and estrogen deficiency in postmenopausal women. The purpose of current study is to know that postmenopausal estrogen therapy may affect the lipid metabolism and endogenous fibrinolytic system and exercise tolerance. METHOD: We investigated the relation of estrogen treatment (srogen 0.625 mg/day) to serum lipid levels, angiotensin converting enzyme activity, plasminogen activator inhibitor-1 and parameters of treadmill test in 22 postmenopausal women of normal coronary artery with abnormal exercise test complained with chest pain accompanied by postmenopausal symptoms. RESULTS: Estrogen treatment significantly elevated the serum HDL-cholesterol level (42.8 to 50.1 mg/dl, p<0.05) and reduced the PAI-1 level (16.2 to 10.4 ng/dl, p<0.01) without considerable side effects. During the exercise test, the positivity appearance time and total exercise duration is significantly increased after estrogen treatment. CONCLUSION: The postmenopausal use of estrogen favorably changed the lipid level, fibrinolytic system and might improve the microcirculation which may protect against the ischemic heart disease risk without significant side effects.
Chest Pain ; Coronary Vessels ; Estrogens* ; Exercise Test ; Exercise Tolerance ; Female ; Humans ; Lipid Metabolism ; Microcirculation ; Myocardial Ischemia ; Peptidyl-Dipeptidase A ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Postmenopause

PURPOSE: Acute diverticulitis of the right colon is not rare in Korea and the clinical presentation is indistin guishable from acute appendicitis. Cecal diverticulitis has led to a controversy in the management of disease. METHODS: Thirty-one cases of acute cecal diverticulitis who underwent operation for suspected acute appendicitis were reviewed retrospectively from January 1995 to December 1998. RESULTS: There were 17 men & 14 women. Ages ranged from 9 to 69 (mean: 37.5) years. All patients presented with signs and symptoms as acute appendicitis. All patients were explored through a transverse incision in the right lower quadrant under the impression of acute appendicitis. An appendectomy and drainage was performed in 13 patients, and resection of the lesion was performed in 18 patients (12 ileocecal resection, one partial cecectomy including appendix, one partial cecectomy and an appendectomy, 4 diverticulectomy and appendectomy), depending on the location of diverticulitis, severity of inflammation, and surgeon. Staples (TA(R), GIA(R)) were used in all cecal resection cases except for diverticulectomy. Five complications were observed, 3 in cecal resection cases (one wound seroma, one wound infection and one bleeding), and 2 in appendectomy and drainage cases (two wound infections). There was no postoperative mortality. The average length of the postoperative stay was 10.2 days in the drainage group and 8.8 days in the cecal resection group. Two recurrences were observed. One was the patient who had diverticulectomy performed. The other was a patient who had had appendectomy and drainage. CONCLUSION: We concluded that the preferred surgical management of an acute cecal diverticulitis operated for a presumed acute appendicitis is cecectomy using staples depending on its location and severity of inflammation. It was safe, relatively easy to do through the same incision, and could be a definitive treatment.
Appendectomy* ; Appendicitis ; Appendix ; Colon ; Diverticulitis* ; Drainage ; Female ; Humans ; Inflammation ; Korea ; Male ; Mortality ; Recurrence ; Retrospective Studies ; Seroma ; Wound Infection ; Wounds and Injuries

PURPOSE: The solid variety of cerebella r tumors in adult is relatively uncommon. This study is to describe the characteristic MR findings of various solid cerebellar tumors in adult. METHODS: Twenty three cerebellar solid tumors from 22 consecutive patients over age of 15 with surgical confirmations were retrospectively evaluated with MR imaging. H istologic diagnosis included hemangioblastoma (n=6), metastasis (n=6), high-grade astrocytoma (n=3), and medulloblastoma (n=8). The MR findings were reviewed with attention to the size, the signal intensity of the tumors, pattern of enhancement, tumoral margin, degree of peritumoral edema, signal void vascular structures within and/or around the tumor, and location in relation to attachment to the pial surface of the tumor. RESULTS: Solid hemangioblastomas consistently showed slightly low or iso signal intensity on T1 -weighted images and high intensity on T2-weighted images, dense homogeneous enhancement, and signal void vessels within and/or around the mass. Metastatic tumors showed various find ings with predominantly low or iso signal intensity on T2-weighted images. Medulloblastomas was midline and/or paramidline in location, and had larger mass formation. High-grade astrocytomas revealed nonspecific MR findings with no signal void vessels. CONCLUSION: Hemangioblastoma, metastasis, malignant astrocytoma, and medulloblastoma should be included in differential diagnosis of solid cerebellar tumors in adult. Dense homogeneous enhancement and signal void vessels are characteristic of hemangioblastoma. The signal intensity of the tumor, and presence of signal void vessels, location and enhancement pattern can be some value in differential diagnosis of solid cerebellar tumors in adult.
Adult* ; Astrocytoma ; Cerebellar Neoplasms* ; Diagnosis ; Diagnosis, Differential ; Edema ; Hemangioblastoma ; Humans ; Magnetic Resonance Imaging ; Medulloblastoma ; Neoplasm Metastasis ; Retrospective Studies

Acute myocardial infarction and subsequent heart failure are leading causes of death worldwide. Stem cell-based therapies have improved cardiac function in recent clinical trials, but cardiomyocyte regeneration has not been demonstrated in human hearts. Angiogenesis and restoration of cardiac perfusion have been successfully performed using bone marrow derived stem cells and other adult stem cells. Resident cardiac stem cells are known to differentiate into multiple heart cell types, including cardiomyocytes. Furthermore, induced pluripotent stem cells are a focus of research due to the great potential for customized stem cell therapy.
Adult Stem Cells ; Bone Marrow ; Cause of Death ; Cell Differentiation ; Heart ; Heart Failure ; Humans ; Induced Pluripotent Stem Cells ; Myocardial Infarction ; Myocytes, Cardiac ; Perfusion ; Regeneration ; Stem Cells