It is currently necessary to manage chronic ischemic foot gangrene because the rate of hospitalization and operations is increasing as a result of diet change and the growth of an aging population. Chronic ischemic foot gangrene is caused by Buerger`s disease, atherosclerosis and particularly, diabetes. In this study, we used the Wagner ischemic index with Doppler flowmeter and Wagner classification on 62 patients over 8 years from 1991 to 1998 as an index for treatment and prognosis. We measured the systolic pressure to determine the ischemic index, and according to Wagner the blood flow was inadequate in cases of diabetic foot gangrene and nondiabetic foot gangrene when it was below 0.45 and 0.35, respectively. According to the observation of clinical symptoms, we divided the cases by Wagner classification. Based on the above data, we performed conservative treatment, skin graft, local flap, superficial sural arterial island flap and amputation. We then followed up the patients and observed the treatment results. We concluded that the Wagner ischemic index with Doppler flowmeter and Wagner classification was useful in determining, selecting, and predicting the rate of survival or death as a result of amputation and graft when a surgical operation is performed.
Aging ; Amputation ; Atherosclerosis ; Blood Pressure ; Classification* ; Diabetic Foot ; Diet ; Flowmeters* ; Foot Ulcer* ; Foot* ; Gangrene ; Hospitalization ; Humans ; Prognosis ; Skin ; Transplants

No abstract available.
46, XX Disorders of Sex Development* ; Female* ; Humans

Transsexuals are those who have appropriate chromosomal, hormonal and anatomical characteristics corresponding to their sexual phenotype but feel strongly with respect to their sexual identity, that they belong to the opposite sex. For this reason, they wish to be reassigned to their psychological sex by means of endocrinological and surgical treatment. Although its etiology is unknown, the majority of modern psychiatrists and behavioral scientists agree that the transsexualism is a disease entity belonging to gender identity disorder or gender dysphoria but not to be confused with the transversite, honosexualism or psychiatric problem. Three kinds of hermaphroditism have been defined according to the histology of the gonad : female pseudohermaphroditism, male pseudohermaphroditism and true hermaphroditism. It is very difficult, if not possible to assign sex especially in neonate and young children. Once sex assignment has been decided and accepted by the patient, surgical intervention should be undertaken as soon as possible. For adults there are many kinds of operative techniques. We have operated 28 cases of transexualism patients by using the penile and scrotal skin flap. This technique is superb for improving sexual appearance and function, and finally for a good opportunity for social activity. We report the results of surgery.
46, XX Disorders of Sex Development ; 46, XY Disorders of Sex Development ; Adult ; Child ; Disorders of Sex Development ; Female* ; Gender Identity ; Gonads ; Humans ; Infant, Newborn ; Male* ; Ovotesticular Disorders of Sex Development ; Phenotype ; Psychiatry ; Skin* ; Transsexualism*

We performed a epidemiologic study to find a prevalence and risk factors of diabetic retinopathy. We reviewed 130 diabetic patients who had been performed the fundus examination for the first time for retinopathy at the ophthalmic department of Chung Ang university hospital from March 1993 to December 1993. We studied epidemiologic work-up sheet and performed ophthalmic and laboratory examination. The patients' ages ranged from 25 to 81 years, with an average age of 58.9 years. The age, sex, intraocular pressure, fasting blood sugar, post cibos 2 hours (Pc2hrs), age of onset, residence, smoking, alcohol drinking, diet pattern, blood type, treatment method and menstruation status were not significantly correlated with prevalence of diabetic retinopathy statistically(p>0.05). But the duration of diabetes(p<0.01), glycosylated hemoglobin(HbA1C) and cataract operation(p<0.05) were significantly correlated with diabetic retinopathy statisically. The prevalence of diabetic retinopathy was 28.5%(background changes in 21.5%, preproliferative changes in 4.6% and proliferative change in 2.4%). The mean interval between diagnosis of diabetes and the first examination of retinopathy was 6.62 years.
Age of Onset ; Alcohol Drinking ; Blood Glucose ; Cataract ; Diabetic Retinopathy* ; Diagnosis ; Diet ; Epidemiologic Studies ; Fasting ; Female ; Hemoglobin A, Glycosylated ; Humans ; Intraocular Pressure ; Menstruation ; Prevalence* ; Risk Factors* ; Smoke ; Smoking

No abstract available.
Angiomyoma

Rigid fixation with metallic plates & screws have been widely used in craniofacial surgery. But the metallic plating system had some problems including intracranial migration, growth restriction, foreign body reaction, infection and artifacts in radiologic evaluation. To overcome these drawbacks, there had been a continuous research on the development of a bioabsorbable skeletal fixation system using polymers of polylactic and polyglycolic acid. There is an increasing acceptance of its application as an alternative fixation device in craniofacial surgery. The resorbable fixation devices have been used in our department between January 2001 and June 2004 in craniofacial surgery. The aim of this retrospective study is to review the complications experienced during this period. We have used the SR-PLDLA(Self reinforecd poly- L/DL-lactide polymer, BioSorbFX(R)) in 131 patients of craniofacial bone fractures. Age varied from 3 to 72 and follow up period varied from 4 months to 40 months. We encountered 4 cases of foreign body reaction, 3 cases of infection and 1 cases of device exposure. In patient showing foreign body reaction, we treated with antibiotics. In case of uncontrolled infection, we removed implants. We think that the resorbable plating system on the rise as alternative method in craniofacial surgery. But more research is needed about its complications.
Anti-Bacterial Agents ; Artifacts ; Follow-Up Studies ; Foreign-Body Reaction ; Fracture Fixation ; Fractures, Bone* ; Humans ; Polyglycolic Acid ; Polymers ; Retrospective Studies

Beau first described transverse depressions of the fingernails after an acute febrile illness in 1846. It was the result of the temporary arrest of nail matrix formation. The transient interference of nail growth rate is usually induced by disability caused by severe systemic disease. Such as Raynaud disease, myocardial infarction, pulmonary embolism, acute renal failure, psoriasis and dysmenorrhea were reported to be the cause of Beau's line. The trauma caused either in a hand or in a forearm was also reported to be the cause of Beau's line. We experienced patients with Beau's line, two cases secondary to fingertip injury and one case due to fracture in radius. They had Beau's lines in all fingers of traumatized hand and nails of opposite hand were normal. During the follow-up, the growth rate of traumatized fingernails were normal and there was no complication.
Acute Kidney Injury ; Depression ; Dysmenorrhea ; Female ; Fingers ; Follow-Up Studies ; Forearm ; Hand Injuries* ; Hand* ; Humans ; Myocardial Infarction ; Nails ; Psoriasis ; Pulmonary Embolism ; Radius ; Raynaud Disease

PURPOSE: Liposarcoma is the most common soft tissue sarcoma, and usually occurs on the thigh or in the retroperitoneal space, but rarely in the oral region. This report presents a case of liposarcoma of the cheek and includes a review of the literatures. METHODS: A 21-year-old woman was admitted with a palpable mass in her cheek of about two years duration, which increased in size gradually initially, but had increased rapidly over the three months. There was no particular pain or tenderness. MRI showed a well-enhanced, well-defined mass, which suspected to be hemangioma. RESULTS: The spherical, well-encapsulated mass was surgically excised. Biopsy results revealed myxoid liposarcoma. FDG PET-CT on the seventh postoperative day, revealed a minimal to mild FDG-uptake soft tissue lesion around the mass defect area without evidence of distant metastasis. The patient is being observed and undergoing radiation therapy. CONCLUSION: Liposarcoma in the head and neck region is a rare disease, and can be overlooked as a benign tumor without a pathologic diagnosis. Therefore, proper treatment and follow-up are required based on an understanding of this disease.
Biopsy ; Cheek ; Female ; Follow-Up Studies ; Head ; Humans ; Liposarcoma ; Liposarcoma, Myxoid ; Neck ; Neoplasm Metastasis ; Rare Diseases ; Retroperitoneal Space ; Sarcoma ; Thigh ; Young Adult

Palatal myoclonus, a kind of objective tinntius, is an uncommon disorder which shows rhythmic involuntary movement of the muscles of soft palate. Because of inadequate response of the muscles involved in palatal myoclonus to medical therapy, injection of botulinum toxin has been considered. We report a case of palatal myoclonus which had not responded to medical therapy. Injection of botulinum toxin into the muscle under the electromyographic guidance showed complete recovery of tinnitus and no more rhythmic movements of the muscles. Electromyography findings before and after botulinum toxin injection were also demonstrated.
Botulinum Toxins ; Dyskinesias ; Electromyography ; Muscles ; Myoclonus* ; Palate, Soft ; Tinnitus*

BACKGROUND AND OBJECTIVE: Mitral annulus velocity measured by doppler tissue imaging (DTI) has been used as a method of evaluation of the left ventricular diastolic function. This study was aimed to evaluate the left ventricular diastolic function using the mitral annulus velocity measured by DTI in the patients with hypertension. METHODS AND SUBJECTS: One hundered twenty nine patients with blood pressure above 140/90mmHg and age sex matched 123 normotensive subjects were studied. For measuring the mitral annulus velocities by DTI, we used the 2.5 MHz probe (Sequoia, Accuson) in apical four chamber view with the sample volume at the septal portion of the mitral annulus. RESULTS: Mitral annular velocities were easily obtained from all subjects. In the hypertension group, mitral annulus E'velocity was significantly lower than normotensive controls (5.4 1.3 cm/sec vs 6.5 1.8 cm/sec, p<0.001) and mitral annulus A' velocity was significantly higher than normotensive controls (8.6 1.4 cm/sec vs 7.9 1.1 cm/sec, p<0.001). In comparison with patients with normal LVML(IV mass index in hypertension group and subjects with normal LVMI in normotensive controls, mitral annulus E'velocity was reduced in patients with normal LVMI in hypertension group compared with subjects with normal LVMI in normotensive controls (5.6 1.4 cm/sec vs 6.7 1.8 cm/sec, p<0.001). CONCLUSION: Mitral annulus velocity measured by DTI could be used as one of the parameters in evaluating the early changes of left ventricular diastolic function in the patient with hypertension.
Blood Pressure ; Humans ; Hypertension*