Secondary cutaneous cryptococcosis may occur earlier than other manifestations of disseminated cryptococcosis. A 68-year-old woman presented with multiple ulcerative lesions on the right calf of 2 weeks duration. She had been treated with antibiotics, but the lesions spread rapidly. The initial clinical impression was necrotizing fasciitis, but routine KOH mounting from the ulcerative lesions showed numerous budding yeast cells with peripheral clear zones and further investigations including a skin biopsy, tissue cultures and India ink preparations allowed a rapid and definitive diagnosis of cutaneous cryptococcosis. Studies for other evidence of infection elsewhere revealed an asymptomatic pulmonary lesion. We report a case of secondary cutaneous cryptococcosis clinically mimicking necrotizing fasciitis that occured before other manifestations of disseminated cryptococcosis.
Aged ; Anti-Bacterial Agents ; Biopsy ; Cryptococcosis* ; Diagnosis ; Fasciitis, Necrotizing* ; Female ; Humans ; India ; Ink ; Saccharomycetales ; Skin ; Ulcer

The clinical study was performed to 28 patients with the pericardiac effusion who were admitted in Busan university Hospital and Paik Hospital, In-Je Medical College, Busan, korea during March 1976 and July 1981. The results were as following; 1) 12 cases(42.9%) of total 28 pericardiac effusion occured in 3rd decade, 8(28.5%) in 2nd decade and 5 cases(17.9%) in 4th decade. Sex distribution showed male to female 2.5:1. 2) With etiological distribution there were 15 cases(53.6%) tuberculous, 5(17.9%) nonspecific, 3(10.7%) malignant, 2(7.1%) pyogenic, 2 traumatic and 1(3.6%) rheumatic. 3) On admission 28 cases(100%) complained of dyspnea, 24(85.7%) distant heart sound, 20(71.4%) each engorged jugular vein and edema, 18(64.3%) each cough and abdominal fullness, 17(60.7%) each sputum and chest discomfort and pain, 12(42.9%) fever, 11(39.1%) orthopnea, 10(35.7%) chilling, 7(25%) oliguria, 4(14.6%) palpitation and 3(17.2%) headache. Increased cardiac dullness was observed in 26 cases(71.4%), hepatomegaly 18(64.3%), pulmonary rales 17(60.7%), ascites 13(46.1%), fever 12(42.9%), pericardiac friction rub 10(35.7%), splenomegaly 7(25%), paradoxical pulse 6(21.4%) and jaundice 2(7.1%). 4) On amission SGOT and SGPT level was increased each in 15(53.6%) and 13(46.7%), TTT and CCF abnormal in 10(35.7%), and 8(28.5%), serum NPN, BUN, creatinine increased in each 10(35.7%), 11(39.1%), 8(28.5%), WBC increased in 6(21.4%), RBC decreased in 8(28.5%) and ESR increased in 16(57.1%). 5) Characteristics of pericardiac effusion showed hemorrhagic 17(60.7%), serosangeous 6(21.4%), sangeous 3(17.2%) and pyogenic 2 cases(7.1%). 6) The ECG on admission revealed low voltage in 25(89.1%), depressed ST segment in 13(46.1%) and inverted T wave in 12(42.9%). 7) Chest X-ray showing cardiomegaly 28(100%), pleural effusion in 20(71.4%), and pulmonary congestion in 16(57.1%). 8) The m mode and 2-D Echocardiogram showed echo free space in 28 cases and after pericardiocentesis the space was reduced or disappeared. 9) 19 cases of 28(67.5%) were improved clinically, while 5 cases(17.9%) were not improved and 4 cases(14.6%) died.
Alanine Transaminase ; Ascites ; Aspartate Aminotransferases ; Busan ; Cardiomegaly ; Cough ; Creatinine ; Dyspnea ; Edema ; Electrocardiography ; Estrogens, Conjugated (USP) ; Female ; Fever ; Friction ; Headache ; Heart Sounds ; Hepatomegaly ; Humans ; Jaundice ; Jugular Veins ; Korea ; Male ; Oliguria ; Pericardiocentesis ; Pleural Effusion ; Respiratory Sounds ; Sex Distribution ; Splenomegaly ; Sputum ; Thorax

No abstract available.
Adult* ; Humans ; Knee* ; Korea*

No abstract available.
Femur* ; Hip Fractures* ; Hip*

No abstract available.
Hip*

The ankle is a complex, weight bearing joint and its injury result in a severe functional disturbance of complex anatomical characteristics. It is very important to understand the mechanism of trauma in order to make definite diagnosis and proper treatment. The authors analysed 52 cases(52 patients) of the ankle fractures which were admitted and treated in Orthopaedic department, Korea University Hospital from Sept. 1980 to Dec. 1986. The results obtained were as follows : l. Of the 52 cases, male was 32 cases(61.5%), female was 20 cases(38.5%) and average age of the patients was 32.9 years. 2. The causes of the injury were slipping down, traffie accident, falling down and sports injuries, in orders. 3. Open fractures were 8 cases(15.4%) and closed fractures were 44 cases(84.6%). The most common type of the ankle fracture was supination-extenal rotation type(18 cases, 34.1%) and next was pronation-external rotation type(15 cases, 30%), according to the classification of Lauge-Hansen. 4. 38 cases(73.1%) were treated by open reduction and 14 cases(26.9%) by closed reduction, and average duration of immobilization was 7.7 weeks in open reduction and 10.4 weeks in closed reduction. 5. The associated fractures other than ankle was 15 cases(28.8%). 6. The better results were obtained from open reduction and the worst results obtained from pronation-dorsiflexion type, according to the criteria of Meyer. 7. The complication was 7 cases(13.5%), traumatic arthritis 4 cases, malunion 2 cases and nonunion 1 case. 8. Accurate reduction and rigid internal fixation of the fractured lateral malleolus, distal fibular and distal tibiofibular diastasis was important in treatment of the ankle fracture.
Accidental Falls ; Ankle Fractures ; Ankle ; Arthritis ; Athletic Injuries ; Classification ; Diagnosis ; Female ; Fractures, Closed ; Fractures, Open ; Humans ; Immobilization ; Joints ; Korea ; Male ; Weight-Bearing

We clinically analyzed 53 patients of fresh femoral neck fractures who were treated in Daegu Catholic Hospital from Aug. 1980 to Apr. 1987: The end results of the surgical methods, i.e. internal fixation, endoprosthesis and total hip replacement, were compared in the 45 patients who were followed for more than 2 years. The results were as follows. 1. The most frequent age occurrence was different in sexes ; male was in the 8th decade (29%) and female was in the 6th decade(31%). 2. The most frequent cause of fracture was “fell from height” in male(43%) and slip down in female(47%).3. Mid cervical fracture was the most frequent in anatomical classification(49%) and 83% of fractures were displaced(Garden stage III & IV). 4. The results were evaluated by the modified Lunceford criteria which included the degree of patient's own satisfaction. The combined result of “excellent” and “good” were obtained in 75% of 20 internal fixation cases, 80% of 15 endoprosthesis cases and 71% of total hip replacement cases. It was concluded that we could get similar results by 3 surgical methods if reasonable criteria of indication were applied for each method: rehabilitation of patient can more important than osteosynthesis itself in the determination of indication of operative methods.
Arthroplasty, Replacement, Hip ; Daegu ; Female ; Femoral Neck Fractures ; Femur Neck ; Humans ; Male ; Methods ; Rehabilitation

The Inyo nail is a new intramedullary device for the treatment of the lateral malleolus. fracture of the ankle with the advantage of rigid fixation. The authors have experieced 16 cases of the Inyo nailing for the ankle fracture and fallowed more than 1 year in the 11 of them. Two groups of patients were evaluated; Group I was treated with the Inyo nail and Group II was treated by conventional technique. The following results were obtained; 1. The Inyo nail was suitable for treatment of type A & B fractures of the ankle. 2. Group I patients resumed their preinjury ROM of the ankles and activity earlier than Group II. 3. The results in the radiographic rating and fuctional criteria were excellent in those cases of Group I than those of Group II.
Ankle Fractures ; Ankle ; Humans

The symphysis pubis is a nonsynovial amphiarthrosis in which the bodies of the two pubic bones are united by a fibrocartilaginous disk. This forms subsidiary tie arches that augment femorsacral arch in the erect position, ischiosacral arch in the sitting position. In normal state the symphysis is strong enough not to be separated. We experienced 5 cases of separated symphysis pubis developed during labor at the Catholic Hospital from January 1987 to December 1988. The duration of follow-up was between 12 and 19 months without any residual symptom after conservative treatment.
Follow-Up Studies ; Pubic Bone

We treated 27 cases of the complete dislocation of the acromioclavicular joint with the modified Weaver and Dunn procedure described by Shoji et al, which is resection of the lateral end of the clavicle and bone block transfer of the coracoacromial ligament, from July 1987 to December 1989. Twenty-one patients were followed for an average of fourteen months and the brief summary of the observations are as follows: 1. The peak incidence was in 3rd and 4th decades and much more prevalent in male (76%). 2. The most common cause of the injury was traffic accident and followed by fall down. 3. In functional evaluation by the Weitzmann criteria, an excellent result was seen in fourteen cases; a good result, in five; a fair result, in two. 4. The comparision of the coracoclavicular interval ratio before surgery with that after surgery facilitated the evaluation of the effectiveness of the coracoclavicular ligament reconstruction. 5. There were no major complications that could affect to end result.
Accidents, Traffic ; Acromioclavicular Joint ; Clavicle ; Dislocations ; Humans ; Incidence ; Ligaments ; Male