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

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.
Electromyography* ; Hand* ; Humans ; Muscle Spasticity* ; Stroke*

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

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 report a case of conjunctival mass with infectious mononucleosis by Epstein-Barr virus (EBV) confirmed with Epstein-Barr encoding region (EBER) in situ hybridization. CASE SUMMARY: A 8 year-old male without underlying disease was referred with counjunctival mass on the right eye starting 3 days ago. In ophthalmologic evaluation, there was injected, nontender, and "salmon patch" appearance conjunctival lesion on right superior bulbar conjunctiva. The patient was admitted to pediatrics with sore throat and fever. The tonsil were enlarged and white blood cell count was 14960/uL. EBV polymerase chain reaction (PCR) test and Viral capsid antigen Immunoglobulin M (VAC IgM) test were positive, the diagnose of infectious mononucleosis by EBV was made. After 5 days steroid eyedrop therapy, biopsy was performed because the lesion was not improved. There were lymphocyte infiltration, chronic inflammation and positive in EBER in situ hybridization. CONCLUSIONS: Elevated and pinkish lesion on conjunctiva, EBV lesion should be considered as differential diagnosis.
Biopsy ; Capsid ; Conjunctiva ; Diagnosis, Differential ; Fever ; Herpesvirus 4, Human* ; Humans ; Immunoglobulin M ; In Situ Hybridization ; Infectious Mononucleosis* ; Inflammation ; Leukocyte Count ; Lymphocytes ; Male ; Palatine Tonsil ; Pediatrics ; Pharyngitis ; Polymerase Chain Reaction

BACKGROUND: Among all gastric cancers, the most frequent malignant tumor in Korea, the proportion of early gastric cancer is increasing. This increase is bringing about controversy on the necessity of gastrectomy with extensive lymph node dissection for treatment. METHODS: Of 923 gastric cancer cases operated on at EulJi Medical Hospital from Jan. 1988 to Dec. 1996, we observed retrospectively 198 cases diagnosed as early gastric cancer on pathological biopsies. We performed this study in order to analyze the prognostic factors affecting recurrence and survival rate and to determine which characteristic of early gastric cancer influences lymph node metastasis. RESULTS: The rate of lymph node metastasis of early gastric cancer was 9.5% and it was revealed that depth of tumor invasion (p<0.0001) and tumor size (p=0.05) affected lymph node metastasis. This comprehensive study on the correlation between lymph node metastasis and such factors as gross type of tumor, depth of tumor invasion, tumor size, and histologic type of tumor indicated that the larger in size, a submucosal cancer in depth, the more depressed in gross type, the poorer in differentiation, the higher the rates of lymph node metastasis were. The 5-year recurrence rate was 4.9%, and the 10-year recurrence rate was 9.6%. Lymph node metastasis had the greatest effect on recurrence, compared with other factors influencing recurrence: depth of tumor invasion (p=0.0358), tumor size (p=0.0054) and lymph node metastasis (p=0.0003). The 5-year survival rate was 95.6% and 10-year survival rate was 91.9%. These survival rates didn't correlate with the depth of tumor invasion (p=0.099), the histologic type (p=0.963) or the gross type (p=0.1324) while the survival rates revealed significant differences (p=0.0337, 0.0032) based on tumor size (<1 100%, 1-2 100%, >2 89.6%) and lymph node metastasis (n 96.3%, n 88.9%). CONCLUSIONS: Lymph mode metastasis is the most influential factor in the survival rate and the recurrence rate of early gastric cancer. We conclude that limited surgery is a reasonable treatment for differentiated mucosal cancers less than 5 cm and selectively for submucosal cancers less than 2 cm with elevation, which have the least possibility of recurrence and lymph node metastasis. However, a gas-trectomy with extensive regional lymph node dissection is still considered to be essential for either submucosal cancer with a depression or the submucosal cancer measuring more than 2 cm in size with elevation since recurrence and lymph node metastasis were frequently seen with these variants.
Biopsy ; Depression ; Gastrectomy ; Korea ; Lymph Node Excision ; Lymph Nodes ; Lymphatic Metastasis* ; Neoplasm Metastasis ; Recurrence* ; Retrospective Studies ; Stomach Neoplasms* ; Survival Rate