Fournier described five patients with gangrene of male external genitalia in 1883 and emphasized three characteristics: (1) abrupt onset in young healthy male, (2) rapid progression to gangrene,(3) absence of discernible cause. But more recent reports described genital gangrene as occurring in any age group and 4 patients in our cases, the mean age was 46 years with an age range of 31 to 59 years. Predisposing causes were as follows: case 1. prostatic calculi, Buerger's disease, case 2, perianal abscess, case 3, diabetes mellitus, case 4, tuberculous spondylitis accompanied by paraplegia and bed sores, liver cirrhosis. The duration of symptoms prior to the development of gangrene varied between 4 to 10 days. The cultured organisms were as follows : case 1. Alpha-hemolytic streptococcus, case 2. E. coli, Alpha-hemolytic streptococcus case 3. Alpha-hemolytic streptococcus, case 4, Mycobacterium tuberculosis, proteus species. Reconstructive surgery of defected scrotum was performed postoperative 8 to 41 days (mean 28.7) and total admission period was 25 to 83 days (mean 46 days).
Abscess ; Calculi ; Diabetes Mellitus ; Fournier Gangrene* ; Gangrene ; Genitalia ; Humans ; Liver Cirrhosis ; Male ; Mycobacterium tuberculosis ; Paraplegia ; Pressure Ulcer ; Proteus ; Scrotum ; Spondylitis ; Streptococcus ; Thromboangiitis Obliterans

In the standing lateral position, the pelvis is tilted in some degree anteroinferiorly. But there was no accurate and standard measurement about the pelvis tilting. The pelvis tilting affects on the lumbar lordosis, weight bearing area of the hip joint, and the anteversion of acetabulum. In the standing true lateral view of the pelvis, 5 points were marked: midpoint of both anterosuperior iliac spines (M), upper margin of symphysis pubis (S), lower margin of symphysis pubis(S), sacral promontorium (SP), coccyx tip (C). And using the additional horizontal plane (H), we measured the 4 angles : angle I ( < MSH), angle II ( < SPSH), angle III(
Acetabulum ; Adult ; Animals ; Coccyx ; Hip Joint ; Humans ; Lordosis ; Pelvis ; Pubic Bone ; Spine ; Weight-Bearing

The patent urachus is the failure of complete urachal lumen closure results in a free communication between the bladder and the umbilicus. The urachus remains patent and urine leaks from the umbilicus. A 53 day old female infant was admitted to Seoul Red Cross Hospital due to urine leakage accompanied by varing purulent discharge from the enlarged protruding umbilicus, measuring 2 Cm x 2 Cm x 2 Cm, since birth. The fistulogram showed a long fistulous tract communicate with bladder and umbilicus. After complete resection of the urachus and umbilicus with a bladder cuff, the patient had no urine leakage from umbilicus. We report a case of patent urachus with some literature.
Female ; Humans ; Infant ; Parturition ; Red Cross ; Seoul ; Umbilicus ; Urachus* ; Urinary Bladder

Among the 65 patients undergoing transurethral resection of the prostate from 1985 to 1988, the complication incidence was significantly higher in 25 patients whose weight of resected prostate was above 20 gm than in 40 patients below 20 gm (p<0.05). So to choose mote proper surgical method, the results of operation, motality and morbity of these 25 TURP patients were compared with 35 open prostatectomy patients whose weight of resected prostate was between 20 gm and 60 gm during same period. The mean incidence of complication for open prostatectomy (60%) was nearly twice that of the TURP (32%) (p<0.05). The age of the patient had no significant influence on the incidence of complication in both groups. In case of the weight of resected prostate below 40 gm complication incidence for the TURP (26.3%) was significantly lower compared with open prostatectomy(66.7%) (p<0.05), but in case of above 40 gm there was no significant difference in both groups. In case of the length of resection below 120 min complication incidence was significantly low in TURP (21.4%) compared with open prostatectomy (61.5%) (p<0.05), but in case of above 120 min. there was no significant difference in both groups. In the open prostatectomy there was no increase in complication incidence by the weight of the gland and the operation time, but in TURP, complicat,40 gm incidence was definitely increased when either weight of the resected prostate was above 40 gm or length of resection was above 120 minutes. Therefore, it seems that TURP is preferable surgical method for benign prostatic hypertrophy unless open surgery is necessarily indicated.
Humans ; Incidence ; Prostate ; Prostatectomy* ; Prostatic Hyperplasia* ; Transurethral Resection of Prostate

There were 18 woman with mild to moderate stress incontinence treated with the Sympathomimetic agents, with were combined with phenylpropanolamine hydrochloride, chlorpheniramine maleate, and isopropamide. The majority of these patients achieved significant improvement for 2 months to 2 and half years after beginning therapy. These patients were performed physical examination, voiding cystourethrogram, stress test lateral-chain cystourethrogram, cystoscopy in order to confirm stress incontinence. We thinked that these conservative therapy were advisable for stress incontinence especially when symptoms were mild.
Chlorpheniramine ; Cystoscopy ; Exercise Test ; Female ; Humans ; Phenylpropanolamine ; Physical Examination ; Sympathomimetics ; Trimeprazine*

BACKGROUND: Aseptic meningitis is a common illness of children. It seems that viruses are the usual etiologic agents. The distribution of these agents mainly depends on the isolated time and region area. This study was performed to isolate the causative viruses from patients with aseptic meningitis in Gwangju area during recent one year. METHODS:A total of 130 patients with aseptic meningitis were evaluated. Stool and/or cerebrospinal fluid specimens from patients were inoculated into rhabdomyosarcoma (RD), HEp2 and Vero cell lines. The virus propagation was examined by the presence of cytopathic effects. Neutralizing tests using enterovirus serum pool were done on each viral isolates. RESULTS: The isolation rate of enterovirus was 24.6% (32/130). The enterovirus isolates were obtained mostly from stool specimens (29/32). Twenty-two isolates were identified by neutralizing test. Ten isolates disclosed 'untyping' by neutralizing test. The distribution of isolates was coxsackievirus group B2 (11 stains, 34.4%), echovirus 30 (4 strains, 12.5%), echovirus 6 (3 strains, 9.4%), echovirus 9, 11, 25 and coxsackievirus group A16 (1 strain, respectively). These strains were predominantly isolated during summer season (June to July). CONCLUSIONS: The causative viruses from patients with aseptic meningitis in Gwangju area during recent 1 year were coxsackievirus group B2, echovirus 30, 6, 9, 11, 25 and coxsackievirus group A16 which were mostly isolated from stool specimens in summer season.
Cerebrospinal Fluid ; Child ; Coloring Agents ; Echovirus 6, Human ; Echovirus 9 ; Enterovirus ; Enterovirus B, Human ; Gwangju* ; Humans ; Meningitis, Aseptic* ; Rhabdomyosarcoma ; Seasons ; Vero Cells

This study was aimed at finding out whether weight reduction alone can improve liver function in obese patients with fatty liver. We did a longitudinal, clinical intervention study on weight reduction by behavior modification, diet and exercise. The study subjects were 25 patients referred to an obesity clinic in whom obesity is the sole factor causing abnormal liver function and fatty liver. Patients were weighed about one year later. We compared the degree of improvement in hepatic function between Group I that showed weight reduction and Group II that showed no-weight reduction. Group I (13) showed dramatic improvement in aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels, nearly all down to within normal levels. AST showed statistically significant improvement from 74 +/- 36 IU/l to 25 +/- 7 IU/l. ALT also showed statistically significant improvement from 109 +/- 67 IU/l to 30 +/- 14 IU/l. Group II (12) showed higher AST and ALT levels on follow-up visit than initial visit. AST showed statistically significant elevation from 43 +/- 11 IU/l to 59 +/- 23 IU/l. ALT also showed statistically significant elevation from 64 +/- 21 IU/l to 97 +/- 33 IU/l. If we can rule the other causes of hepatic abnormalities in obese patients with fatty liver, we suggest these patients would benefit by weight reduction.
Adolescent ; Adult ; Alanine Transaminase/metabolism ; Aspartate Aminotransferases/metabolism ; Body Weight/physiology ; Comparative Study ; *Diet, Reducing ; Fatty Liver/complications/*diet therapy/physiopathology ; Female ; Human ; Liver/enzymology/*physiopathology ; Longitudinal Studies ; Male ; Middle Age ; Obesity/complications/*diet therapy/physiopathology

Free flaps have been widely used in lower leg reconstruction. However, in cases with extensive injury to the vessels as well as to the bone and soft tissues, and having only one intact major vessel in the lower leg(single vessel leg), careful selection of recipient vessels for the free flap transfer is mandatory for preventing further vascular compromise of the distal lower leg. The sural artery and its vena comitantes are frequently protected form externally harmful forces by the bulky surrounding gastrocnemius muscle and can be used as recipient vessles for free flaps without any detrimental influence on the vascularity of the distal lower leg. In our department, three latissimus dorsi muscle free flap were transferred with sural vessels as recipient vessels in the reconstruction of the single vessel legs. Except for one case of flap failure due to serious infection at the microvascular anastomoses site, all the other cases were successfully reconstructed without any necrosis of the gastrocnemius muscle or the distal leg. In addition, the sural vessels were easily accessed in any patient position and their caliber was similar to that of the vascular pedicles of the donor muscle flaps. In conclusion, the sural vessels can be another useful option in selecting recipient vessels for free flap transfer in the reconstruction of the single vessel leg.
Arteries ; Free Tissue Flaps* ; Humans ; Leg* ; Muscle, Skeletal ; Necrosis ; Superficial Back Muscles ; Tissue Donors

A 13-year-old girl developed rice to nut-sized, bluish to slate-gray colored, depressed patches in a zosteriform distribution along the right side of her upper back and arm without any symptoms. Microscopically, the lesions showed a normal-appearing epidermis, dermis, and subcutaneous fat tissue except for a thinning of collagen fibers and widening of intervals between them in the lower dermis. There have been no changes to the skin lesions during the last 2 years.
Adolescent ; Arm ; Collagen ; Dermis ; Epidermis ; Female ; Humans ; Skin ; Subcutaneous Fat

The gag encoded p24 protein of human immunodeficiency virus-1 (HIV-1) is a major constitutent of the viral core, and is also known as one of the most immunodominant antigens in the host immune response against the HIV-1. Based on the neutralizing ability of anti-p24 antibodies as well as their rapid appearance in human serum after viral infection, the development of vaccines and diagnostic tools targeting the p24 protein and anti-p24 antibodies is of great interest. For the characterization of the immunological properties of the HIV-1 p24 protein, in a previous study, putative B-cell epitopes were identified by screening the reactivity of a goat anti-p24 antiserum to a large array of overlapping synthetic peptides covering the whole p24 sequence. Four peptides were identified for their abilities to elicit a strong B-cell response, which sequences comprises the regions p24 (164-182), (202-221), (217-236) and (232-256), respectively. In the present study, the immunogenicity and differential properties of each of these individual epitopes were further characterized. To evaluate the time course of the antibody response, BALB/c mice were immunized with the HIV-1 p24 protein and their serum titers against each of these peptides were determined. The earliest immune response was observed against the p24 (202-221) peptide, which also showed the highest antibody titer against the immunized antigen. Furthermore,. enzyme-linked immunosorbent assay with HIV-1 p24 protein coated microtiter plates revealed that anti-p24 (202-221) antiserum has the most pronounced reactivity against the native p24 protein. Since the p24 (202-221) epitope has also been reported to include a cytotoxic T-lymphocyte epitope, it is suggested that this region might represent a powerful antigenic site responsible for eliciting both T- and B-cell immune response. The possible application of this specific epitope in vaccine development or AIDS diagnosis is discussed.
Animals ; Antibodies ; Antibody Formation ; B-Lymphocytes ; Diagnosis ; Enzyme-Linked Immunosorbent Assay ; Epitopes* ; Epitopes, B-Lymphocyte ; Goats ; HIV* ; HIV-1 ; Humans ; Immunodominant Epitopes ; Mass Screening ; Mice ; Peptides* ; T-Lymphocytes, Cytotoxic ; Vaccines