We reviewed thrity-one cases of unstable tibial fractures treated with Ilizarov method from January 1991 to December 1992. We attained satisfactory bony union in all cases without bone graft(Average time 19.2 weeks). There were numbers of complications, but its were soluble and careful management & numbers of minor surgery were needed to prevent & solve such complications. Post-op immediate weight bearing and ROM exercise were possible and showed no difficulty in getting mainteance of reduction & fracture healing, and serious joint ankylosis was not developed. In conclusions, Ilizarov method is an excellent treatment in getting reduction, maintenance of reduction, early ambulation and fracture healing in the cases of unstable tibia fractures.
Ankylosis ; Early Ambulation ; Fracture Healing ; Ilizarov Technique ; Joints ; Minor Surgical Procedures ; Tibia ; Tibial Fractures ; Weight-Bearing

Authors clinically analysed the end results of the 58 elderly patients having fresh femoral neck fracture who were treated with multiple Knowles pinning, compression hip screw and femoral head replacement. All these 58 patients were treated between January 1982 and December 1986 at the Presbyterian Medical Center, Chonju. The factors that influenced the clinical results were analysed by type of fractures, early and late post-operative complications, quality of the fractured bone(osteoporosis), and functional evaluation with Jesse's hip grading method at least post-operative two year later. The results were summerized as follows : 1. The slip down was the most common cause of injuries. The transcervical type and Garden's type 153 was the most common type of fractures. 2. Average time interval between injury and diagnosis is 6 days. In case of delayed diagnosis, the fractures showed more displacement. 3. The osteoporotic change of femoral neck and spine was increased as physiological age advanced in parallel. 4. As the osteoporosis advanced, the fractures showed more displacement. 5. As the kosteoporosis advanced, the final results were worse, 6. The group treated with compression hip screw showed less complication and better functional result than patients operated with multiple knowles pinning. 7. This study suggests that the important factors that influenced the clinical results were type of fracture, the interval between injury and operation, method of trearment, and the quality of the fractured bone(degree of osteoporosis).
Aged ; Clinical Study ; Delayed Diagnosis ; Diagnosis ; Femoral Neck Fractures ; Femur Neck ; Head ; Hip ; Humans ; Jeollabuk-do ; Methods ; Osteoporosis ; Protestantism ; Spine

No abstract available.
Dermatofibrosarcoma

BACKGROUND: Impetigo is a common bacterial infection caused by Staphylococcus aureus, and group A beta-hemolytic Streptococcus or both. Recently, S. aureus has been reported as the most frequently isolated pathogen of impetigo and the incidence of methicillin-resistant S. aureus (MRSA) among patients with impetigo has increased. OBJECTIVE: To investigate the predominant microorganism and the antibiotic susceptibility of the impetigo causative pathogen. METHODS: Bacterial culture and antimicrobial susceptibility testing were performed in patients with impetigo from June 2006 to May 2012. RESULTS: Of 164 patients, bacteria were cultured from 139 patients. Among them, S. aureus was isolated from 114 (82%) patients. The others were Acinetobacter baumannii, Enterobactercloacae, Enterococcus species, Enterococcus faecium, Enterococcus faecalis, Klebsiella oxytoca, and Candida albicans. The resistance rates of S. aureus against antibiotics were as follows: penicillin, 95.6%; erythromycin, 43.9%; fusidicacid, 38.1%; clindamycin, 24.5%; gentamycin, 21%; tetracycline, 12.3%; trimethoprim-sulfamethoxazole, 0.9%; ciprofloxacin, 0%; habekacin, 0%; linezolid, 0%; teicoplanin, 0%; and vancomycin, 0%. Thirty-four (29.8%) S. aureus isolates were MRSA, and the prevalence of MRSA increased during the 6-year period. CONCLUSION: The most predominant pathogen in impetigo was S. aureus, which was sensitive to ciprofloxacin, habekacin, linezolid, trimethoprim-sulfamethoxazole, teicoplanin, and vancomycin. An increase in the prevalence of MRSA was observed during the 6-year period, and the effective antibiotics for MRSA were trimethoprim-sulfamethoxazole, teicoplanin and vancomycin.
Acetamides ; Acinetobacter baumannii ; Anti-Bacterial Agents ; Bacteria ; Bacterial Infections ; Candida albicans ; Ciprofloxacin ; Clindamycin ; Dibekacin ; Enterococcus ; Enterococcus faecalis ; Enterococcus faecium ; Erythromycin ; Gentamicins ; Humans ; Impetigo ; Incidence ; Klebsiella oxytoca ; Methicillin Resistance ; Methicillin-Resistant Staphylococcus aureus ; Oxazolidinones ; Penicillins ; Prevalence ; Staphylococcus aureus ; Streptococcus ; Teicoplanin ; Tetracycline ; Trimethoprim, Sulfamethoxazole Drug Combination ; Vancomycin ; Linezolid

BACKGROUND: Bowen's disease is a challenging condition to treat because lesions often affect the elderly who are usually intolerable to invasive treatment modalities and lesions are often located at sites that heal poorly. OBJECTIVE: The aim of this study was to evaluate the effectiveness and the safety of 5% imiquimod cream for the treatment of Bowen's disease. METHODS: Eleven patients with biopsy-proven Bowen's disease were treated with once-daily or twice-daily self- application of 5% imiquimod cream for a maximum of 16 weeks. RESULTS: Nine of ten (90%) patients who completed the treatment schedule showed complete clinicopathologic regression. One (11%) patient showed recurrence of Bowen's disease on the treated site. 5% imiquimod cream was generally well-tolerated and no serious side effects were observed. CONCLUSION: 5% imiquimod cream appears to be an effective modality for treatment of Bowen's disease and might represent a valuable alternative to surgery or other invasive treatment methods.
Aged ; Appointments and Schedules ; Bowen's Disease* ; Humans ; Recurrence

A 29-year-old man presented with well-demarcated brown-to-erythematous patches with scales on the perioral and periocular areas. We could not find any other systemic signs and symptoms, except for the cutaneous findings and no abnormal results were found on laboratory tests. Histologic examination showed upper dermal granulomatous infiltrate and led us consider the diagnosis of granulomatous periorificial dermatitis. After daily taking oral minocycline 200 mg with application of topical tacrolimus ointment for 8 weeks, combined with the application of topical tacrolimus ointment, the lesion showed a marked improvement without scarring.
Adult ; Cicatrix ; Dermatitis ; Dermatitis, Perioral ; Humans ; Minocycline ; Tacrolimus ; Weights and Measures

Semicircular lipoatrophy is a rare entity characterized by atrophic cutaneous indentation, typically involving the anterolateral thigh of young women. Although many previous reports have failed to reveal underlying trauma histories, repeated external microtraumas seem to be the most plausible causal factor at present. We report a case of semicircular lipoatrophy which occurred on both thighs of a 23-year-old woman after she started a new job as a waitress in fast-food restaurant.
Female ; Humans ; Restaurants ; Thigh ; Young Adult

Immunosuppressive therapy has been reported to exacerbate or initiate the development of porokeratosis. We report a patient who noted a dramatic worsening of previously unrecognized lesions of porokeratosis accompanied by malaise and fatigue. He was subsequently found to have myelodysplastic syndrome. On the basis of this case, the sudden appearance or exacerbation of disseminated porokeratosis without immunosuppressive therapy may justify the search for underlying immunodepressive conditions.
Fatigue ; Humans ; Myelodysplastic Syndromes* ; Porokeratosis*

PURPOSE: Small-sized carcinoids, less than 1 cm, are easily detected using flexible sigmoidoscopy or total colonoscopy and can be treated by local excision. Recently, there has been many advances in the technique of endoscopic resection. The aim of this study was to determine the endoscopic findings of a rectal carcinoid and to evaluate the effectiveness of endoscopic resection. METHODS: We experienced 22 rectal carcinoids in 21 patients who were treated by endoscopic resection from June 1996 to February 1999. Nineteen cases were followed for an average of 21 months. Follow-up studies consisted of chest P-A, hepatic ultrasonography, and total colonoscopy. RESULTS: The male-to-female ratio was 1.6 to 1. The most common age group was the 4th decade. The tumor was located at the lower rectum in 10 patients, at the upper rectum in 10 patients, and at the rectosigmoid junction in 2 patients. The tumor sizes ranged from 3 to 12 mm in diameter and were smaller than 10 mm in 20 cases (90.1%). Endoscopic finding revealed that the tumors were covered by a normally appearing mucosa in 12 cases, were yellow-discolored polyps in 17 cases, and were sessile-type tumors in 19 cases. The method of treatment was an endoscopic mucosal resection (EMR, 14 cases) or a snare polypectomy (8 cases). Microscopically positive margins were noticed in four cases, two cases of EMR (2/14, 14%) and two cases of snare polypectomy (2/8, 25%). All the patients were alive and clinically free of disease; however, the duration of the follow-up is short. CONCLUSIONS: Endoscopic resection for rectal carcinoid tumors smaller than 1 cm in diameter is a safe, functional, time-saving, and effective treatment. If the tumor suggests a carcinoid, EMR is advised rather than a polypectomy even though the tumor is small. Microscopically positive margins are not absolute indications for further surgery in the treatment of carcinoids smaller than 1 cm in diameter. It is much more important for an endoscopist to be confident that the endoscopic resection is done completely. It is necessary to identify the factors influencing the malignancy potential and to have a longer follow-up.
Carcinoid Tumor* ; Colonoscopy ; Follow-Up Studies ; Humans ; Mucous Membrane ; Polyps ; Rectum ; Sigmoidoscopy ; SNARE Proteins ; Thorax ; Ultrasonography

This study compares the sexual differences among rectal prolapse patients regarding the clinical and the physiologic characteristics with emphasis on males. METHODS: The clinical data, functional status and operative records of 43 patients, who had completed both clinical and functional evaluations were collected in a prospective database and were analyzed according to sex. The functional status of the patients was evaluated by Wexner's constipation score (0~30), Wexner's incontinence score (0~20), anorectal manometry, and pudendal nerve terminal motor latency (PNTML). RESULTS: The incidences of rectal prolapse in males (n=22) and in females (n=21) were similar. The age of onset for males was lower (mean standard deviation, 19.6 19.59 (50% in childhood) vs 52.0 20.75 years; p=0.001) and the duration of symptoms was longer (31.5+/-19.87 vs 12.5+/-14.31 years; p<0.001). Surgery in males was most commonly performed during the sexually active years (51.2+/-16.34 vs 64.5+/-13.19; p=0.006). The incidence of mucosal prolapse in males was higher (10/22 vs 4/17; p=0.065). The incidences and the severities of defecation difficulty in males and females were similar (n=12, mean Wexner score=8.4 vs n=12, mean Wexner score=9.9; p=NS) but, the incidences and the severities of fecal incontinence were lower in males (n=4, mean Wexner score=4.3 vs n=17, mean Wexner score= 14.2; p<0.001). The maximum resting pressure was higher in males (39.2+/-21.46 vs 26.3+/-19.98 mmHg; p=0.049), and the maximum squeezing pressure was better preserved (131.2+/-62.63 vs 67.5+/-37.99 mmHg; p<0.001). No significant difference existed in the PNTML. Female patients underwent abdominal resection rectopexy (n=6), perineal rectosigmoidectomy with lavatoroplasty (n=11), and Delorme's procedure (n=4), but all male patients preferred the perineal approach (rectosigmoidectomy with lavatoroplasty (n=8), Delorme's procedure (n=14)) for fear of sexual dysfunction after the abdominal approach. CONCLUSIONS: These findings suggest that the mechanism for developing rectal prolapse in male and female may be different and that surgical treatment should be tailored to the patient.
Age of Onset ; Constipation ; Defecation ; Fecal Incontinence ; Female ; Humans ; Incidence ; Male* ; Manometry ; Prolapse ; Prospective Studies ; Pudendal Nerve ; Rectal Prolapse*