Fournier's gangrene is a rare infection with high mortality rate. it consists of a mixed bacterial infectin of the skin, subcutaneous tissues and superficial fascia of the perinium and genitalia. Old patients especially with diabetes mellitus, alcoholism and maligancy are more affected. This disease requires prompt treatment: early diagnosis, broad spectrum antibiotic therapy, nutritional support and immediate extensive surgial debridement are necessary We report one case of Fournier's gangrene associated with diabetes mellitus.
Alcoholism ; Debridement ; Diabetes Mellitus ; Early Diagnosis ; Fournier Gangrene* ; Genitalia ; Humans ; Mortality ; Nutritional Support ; Skin ; Subcutaneous Tissue

BACKGROUND: Epidermal grafting using cryotherapy for recipient sites is in widespread use. However the peripheral hypopigmented haloes that occur around the recipient sites require prolon gation of the treatment period. OBJECTIVE: We used a CO2 laser to remove the epidermis of the recipient sites for betteri results. METHODS: We treated lie localized vitiligo patients with CO2 laser to remove t.he epidermis and grafted suction blister rooves. We observed repigmentation and complications 1 month later. RESULTS & CONCLUSIONS : The superiority of this method is demonstrated by the fact 1) all prodedures can be completed on the day of operation 2) the incidence of hypertrophic scar and peripheral hypopigmented halos can be observed.The problems of this method are 1) uneven repigmentation of recipient. sites 2) hyperpigrnentation of recipient sites
Blister ; Cicatrix, Hypertrophic ; Cryotherapy ; Epidermis* ; Humans ; Incidence ; Lasers, Gas* ; Suction ; Transplants* ; Vitiligo*

No abstract available.
Brain* ; Hemangioendothelioma* ; Lung* ; Mediastinum*

Early MRI and arthroscopic findings were compared to evaluate the efficacy of the former for patients, who upon physical examination, were diagnosed with possihle acute ACL tears. MRI, taken between 1-21 days after injury, had to reveal complete ACL tears and arthroscopic surgery should have taken place 3-12 weeks after the injury for patients of this prospective study. Fifty such cases were initially catagorized according to five MRI patterns. Types I to V were separated by the following ACL tear characteristics: Enlarged and diffusely increased in signal, horizontally oriented, non-visualized, discontinuous and vertically oriented. The cases were then divided into two groups of arthroscopic findings; Group A included cases of complete ACL tearing and group B included those with intact or minimally torn ACLs. Of MRI types I through V, there were 31, 9, 5, 4, and I cases of each respectively. 37 cases resulted in complete ACL tears (21 type I, 6 type II, 5 type III, 4 type IV and 1 type V) and 13 cases were catagorized into group B, 10 of which had pattern type I and 3 of which had pattern type II. As result, types III, IV and V had a 100% Positive Predictive Value (PPV) whereas types I and II together had a 67% PPV vaiue. Division of the cases into the five pattern types in early MRI proved valuble for possible cases of acute ACL tears. MRI pattern types III, IV and V were correlated with definite complete ACL tears. However, caution must be taken for types I and II, the majority of the cases, for which there exists a significant possibility for misdiagnosis and consequently unnecessary arthroscopic surgery.
Arthroscopy ; Diagnostic Errors ; Humans ; Knee ; Magnetic Resonance Imaging* ; Physical Examination ; Prospective Studies

No abstract available.
Electromyography* ; Hand* ; Humans ; Muscle Spasticity* ; Stroke*

Anatomy of the pancreaticobiliary ductal system is so variable that one should think of its normal anatomy as nonexistent. But exact location of the termination of the common bile duct in important to the biliary surgeon when performing transduodenal exploration of the common bile duct, to the physician and radiologist when diagnosing pancreaticobilijary disease by ERCP. We report a case of Lnomalous termination of the common bile duct into thii. duadenal bulb diagnosed by ERCP and operative cholangiogram.
Cholangiopancreatography, Endoscopic Retrograde ; Common Bile Duct*

We experienced a case of mitral incompetence due to rupture of anterolateral papillary muscle in a 56-year-old male who complained of abdominal pain and mild dyspnea after being struck by car. Clinical manifestation immediately following injury was minimal, but heart failure progressed rapidly 3 days after injury. Echocardiopraphic evaluation revealed ruptured anterolateral papillary muscle and severe mitral regurgitation on color flow imaging. There was no evidence of coronary artery disease on coronary angiography. Operation revealed that the haed of anterolateral papillary muscle was torn out of its insertion. Mitral valve replacement with mechanical prosthesis was performed on the 50th day after injury.
Abdominal Pain ; Coronary Angiography ; Coronary Artery Disease ; Dyspnea ; Heart Failure ; Humans ; Male ; Middle Aged ; Mitral Valve ; Mitral Valve Insufficiency ; Papillary Muscles* ; Prostheses and Implants ; Rupture* ; Thorax*

Sixty-six patients with squamous cell carcinoma of the cropharynx were treated with radiation therapy and retrospectively analyzed to evaluate the treatment result in the Department of Therapeutic Radiology, Korea Cancer Center Hospital between January 1980 and December 1986. There were 42 patients with carcinoma of the tonsil including the fossa and pillar, 9 patients with carcinoma of the base of tongue, 12 patients with carcinoma of the soft palate, and 3 patiens with carcinoma of the posterior and lateral pharyngeal walls. Considering all oropharyngeal sites of involvement together, response rates for T1, T2, T3, and T4 were 80%, 77%, 73%, and 40%, respectively, with a overall response rate of 70%. The response rate for N1, N2, and N3 were 69%, 63% and 40%, respectively, with the overall regional response rate of 70%. In lower T status, undifferentiated carcinoma and primary tumor arising from the soft palate, higher response rates were obtained. The 5 year overall and disease-free survival rate were 56%, 55%, respectively. A better prognosis was obtained in early T tage(T1+T2)(p<0.01) and in patients without tumor extension into adjacent structures in carcinomas arising from tonsillar area(p<0.01). Though this study we suggest that, in terms of anatomical and functional preservation, radiation therapy seems to be an effective method for the primary treatment of patients with radiation therapy seems to be an effective method for the primary treatment of patients with oropharyngeal carcinoma.
Carcinoma ; Carcinoma, Squamous Cell ; Disease-Free Survival ; Humans ; Korea* ; Oropharynx ; Palate, Soft ; Palatine Tonsil ; Prognosis ; Radiation Oncology ; Radiotherapy* ; Retrospective Studies ; Tongue

PURPOSE: To evaluate the diode laser photodynamic therapy efficacy on choroidal neovascularization (CNV) in the treatment of three patients with age-related macular degeneration (ARMD). METHODS: The authors selected three patients with ARMD whose vision has decreased due to CNV, and applied diode laser treatment after injecting an indocyanine green (ICG) solution. The patients were followed for at least three months after treatment, and examinations included evaluating vision changes and possible leakage on fluorescein angiography (FAG). RESULTS: The final vision of two patients improved by more than one line on the Early Treatment Diabetic Retinopathy Study (ETDRS) chart after at least three months of follow-up. However, the final vision of the third patient decreased by one line on ETDRS chart. FAG was done in all patients, and in two of the patients, there was no evidence of leakage at the laser-applied site. In the other patient, there was evidence of minimal leakage, with the area of leakage decreasing by more than fifty percent. Side effects of ICG were not found during or after the photodynamic therapy sessions. CONCLUSIONS: The photodynamic usage of ICG treatment of CNV in patients with ARMD, was effective in preventing or improving the visual outcome. Compared to the widely used verteporfin, ICG is more stable and is more cost effective. The authors therefore came to a conclusion that ICG can be very useful in the treatment of CNV. However, further studies are necessary.
Treatment Outcome ; *Photochemotherapy ; Middle Aged ; Male ; Macular Degeneration/*drug therapy ; Lasers/*therapeutic use ; Indocyanine Green/*therapeutic use ; Humans ; Female ; Coloring Agents/*therapeutic use ; Aged

No abstract available.
Angiofibroma ; Carbon ; Carbon Dioxide ; Lasers, Gas