Diabetic gangrene is a common complication of diabetes mellitus, and its an incidence which has an increasing tendency. And its treatment is very difficult because of the high incidence of delayed wound healing. The diagnostic method to determine the level of amputation for treatment of ischemic limb was reported by many authors, but it still has many controversies. From January 1973 to December 1982, 60 cases in 55 patient of diabetic gangrene were treated at the Department of Orthopedic Surgery Severance Hospital. The result of treatment of diabetic gangrene according to the level of amputation, primary healing rates, and complication were studied. The results obtained are as follow; l. Among 55 patients, 34 male and 21 female, 50 patients(90.9%) were older than 51 years. 2. There was no correlation between primary healing and palpating arterial pulsation at the amputation level, also there was no correlation between primary healing and obstruction of proximal artery in arteriography. 3. It wasrecommended to correct hemoglobin level above 12.1gm% before treatment for primary healing at the operation site. 4. Debriment and skin graft were indicated with the grade I lesion. Whenever they amputate and attempt to do primary healing at the operation site, the ideal level is the site where the skin temperature is between 33.1℃ to 34℃. 5. High delayed healing rate(71.4%) was anticipated in below knee amputation with grade IV lesion with low skin temperature(below 32℃). 6. Among 12 patients who took Pylon prosthesis and started early weight bearing walking after major amputation, 10 patients(83.3%) were healed orimarily. 7. Operative mortality was 5.4% and 5 year mortality after operation due to diabetic gangrene was 16.9%.
Amputation ; Angiography ; Arteries ; Clinical Study ; Diabetes Mellitus ; Extremities ; Female ; Gangrene ; Humans ; Incidence ; Knee ; Male ; Methods ; Mortality ; Orthopedics ; Prostheses and Implants ; Skin ; Skin Temperature ; Transplants ; Walking ; Weight-Bearing ; Wound Healing

No abstract available.
Heart* ; Thoracic Surgery*

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

Surgical intervention during the pregnancy is not rare and the impact of anesthesia and surgery during the pregnancy is doublefold, because the mother and the fetus in uterus are concerned. The anesthesiologist must know the progressive' maternal changes during the pregnancy and drug action on the fetus. The authors have experienced 50 cases of pregnant women undergoing various kinds of operation and have analyzed those cases according to the type of disease, the duration of gestation, physical status, premedication, anesthetic technics and agent used, and the outcome of the fetus and the patient during the period between March 1972 to August 1978 The results were as follows: 1) The most of patient, 32 cases were operated for the obstetric and gynecological :reason s. 2) 27 cases (54%) had undergone the operation during the second trimester. 3) Physical status class 2 including 28 cases (56%) was the most commonly found physical status of the patients. 4) Halothane was the main anesthetic agent for 39 cases (78%) and there were 3 cases of spinal anesthesia. 5) We could follow 27 cases among 50 cases about the outcome of the fetus. 17 spontaneous vaginal delivery, 8 Cesarean sections, 1 fetal death in uterus and 1 wanted D&C. 6) Among 5 premature deliveries, 2 premature infants died during the hospitalization. 7) The only maternal motality was the case of intrahepatic stone who expired 11 days postoperatively and delivered a 1,300 gm premature 7 days postoperatively.
Anesthesia ; Anesthesia, Spinal ; Cesarean Section ; Dilatation and Curettage ; Female ; Fetal Death ; Fetus ; Halothane ; Hospitalization ; Humans ; Infant, Newborn ; Infant, Premature ; Mothers ; Pregnancy ; Pregnancy Trimester, Second ; Pregnant Women ; Premedication ; Uterus

No abstract available.
Atrial Fibrillation* ; Heart* ; Thoracic Surgery*

Although hypoxic pulmonary vasoconstriction (HPV) has been recognized by many researchers, the precise mechanism remains unknown. As isolated pulmonary arteries will constrict in vitro in the response to hypoxia, the oxygen sensor/transduction mechanism must reside in the pulmonary arterial smooth muscle or in the endothelium, or in both. Unfortunately, much of the current evidence is conflicting, especially as to the dependency of HPV on the endothelium and the role of a K+ channel. Therefore, this experiment was attempted to clarify the dependency of HPV on the endothelium and the role of a K+ channel on HPV in rat pulmonary artery. The effects of hypoxia were investigated in isolated main pulmonary arteries precontracted with norepinephrine. Vascular rings were suspended for isometric tension recording in an organ chamber filled with a Krebs-Henseleit solution. Hypoxia was induced by gassing the chamber with 95% N2 + 5% CO2 and this was maintained for 20 min. Hypoxia elicited a vasoconstriction in arteries with endothelium. Mechanical disruption of the endothelium abolished HPV. There was no difference between the amplitude of the HPV induced by two consecutive hypoxic challenges and the effect of normoxic and hyperoxic control Krebs-Henseleit solution on a subsequent response to hypoxia. Inhibition of NO synthesis by treatment with N(omega)-nitro-L-arginine reduced HPV, but inhibition of a cyclooxygenase pathway by treatment with indomethacin had no effect on HPV. Blockades of a tetraetylammonium chloride-sensitive K+ channel abolished HPV. Verapamil, a Ca2+ entry blocker reduced HPV. In conclusion, these results suggest that HPV was dependent on the endothelium and that HPV can be considered to be induced by inhibition of the mechanisms of NO-dependent vasodilation such as the opening of a K+ channels.
Animal ; Anoxia/physiopathology* ; Blood Vessels/physiopathology ; Calcium Channel Blockers/pharmacology ; Cyclooxygenase Inhibitors/pharmacology ; Enzyme Inhibitors/pharmacology ; Indomethacin/pharmacology ; Nitroarginine/pharmacology ; Pulmonary Circulation/physiology* ; Pulmonary Circulation/drug effects ; Rats ; Tetraethylammonium/pharmacology ; Vasoconstriction/physiology* ; Vasoconstriction/drug effects ; Verapamil/pharmacology

No abstract available.
Sarcoma*

Severe recurrent attacks of acute febrile neutrophilic dermatosis shortly followed multiple keratoacanthoma in a 43-year-old man with myelodysplastic syndrome. Besides the typical clinicopathological findings of the syndrome(fever, leukocytosis and neutrophilic erythematous plaques of the skin), the patient showed orolingual and conjunctival ulceration and severe cutaneous pathergic reactions. Moreover, to the best of our knowledge, multiple keratoacanthoma has not yet been reported with relation to the acute febrile neutrophilic dermatosis.
Adult ; Humans ; Keratoacanthoma* ; Leukocytosis ; Myelodysplastic Syndromes ; Neutrophils ; Sweet Syndrome* ; Ulcer

PURPOSE: The Purposes of this study are to identify the circulating etiologic viruses of acute lower respiratory tract infection in children and to understand the relation with clinical diagnosis. METHODS: We obtained a total of 418 nasopharyngeal aspirates from children admitted for their acute lower respiratory tract infections at three tertiary hospitals in Seoul from September 2008 to March 2009. We performed multiplex RT-PCR to identify 14 etiologic viruses and analyzed their emerging patterns and clinical features. RESULTS: Average age of patients was 16.4 months old and the ratio of male to female was 1.36. Viruses were detected in 56.2% of a total of 418 samples. Respiratory syncytial virus (35%) was the most frequently detected and followed by human rhinovirus (22%), human bocavirus, adenovirus, human metapneumovirus, parainfluenza virus, influenza virus and human coronavirus. Co-infection reached 21.9% of positive patients. CONCLUSION: When we manage the patients with acute lower respiratory infectious diseases, we should remind the role of various viral pathogens, which might be circulating by seasons and by local areas.
Adenoviruses, Human ; Child ; Coinfection ; Communicable Diseases ; Coronavirus ; Female ; Human bocavirus ; Humans ; Male ; Metapneumovirus ; Orthomyxoviridae ; Paramyxoviridae Infections ; Respiratory Syncytial Viruses ; Respiratory System ; Respiratory Tract Infections ; Rhinovirus ; Seasons ; Tertiary Care Centers ; Viruses

No abstract available.
Angiofibroma ; Carbon ; Carbon Dioxide ; Lasers, Gas