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.
Parenteral Nutrition, Total

It is generally accepted that in acute pancreatitis, the enzymes normally excreted by the pancreas are released from the disrupted parenchyma into the extraductal space and taken up by way of the lymphatics and capillaries. The enzymes in the blood stream may appear in high concentration in the serum. Therefore, serum amylase and lipase determinations has long been a mainstay in the diagnosis of acute pancreatitis and other pancreatic diseases. However, many investigators have claimed that the urinary output of amylase may be elevated more consistently in acute pancreatitis than in the serum concentration of either amylase or lipase, and urinary amylase measurement is a more sensitive reflection of the presence of pancreatitis and of its clinical course than is the measurement of serum amylase or lipase. Clinically, one of the ominous signs which may develop during the early course of acute pancreatitis is severe hypotension. But, no agreement has been reached among investigators as to the cause of the hypotension, although several investigators have implicated a blood volume deficiency resulting form inflammatory process, and hypercalcemia. Perhaps, the majority have attributed the hypotension to systemic effect of some of the pancreatic enzymes, especially trypsin. Nevertheless, the correction of these factors sometimes fail to restore a normal blood pressure clinically. The purpose of the present investigation was to observe the relationships between serum concentration and urinary output of pancreatic enzymes, and to determine the degree of hypotension resulting from the systemic administration of pancreatic enzymes. These experimental procedures, consisted of heteroinfusion of human pancreatic juice and homoinfusion of canine pancreatic emulsion intravenously, and pancreatic ductal ligation in dogs. Blood and urine samples for the enzyme analysis were collected serially thorough the femoral vein and ureteral catheter before and after the procedure. Blood pressure was measured consistently by the kymograph before and after infusion of pancreatic juice. Activities of amylase and lipase were determined by methods of Nelson and, Cherry and Crandall, respectively. The results obtained are summarized as follows; 1. Following intravenous infusions of pancreatic juice exogenously. serum and urine concentrations of amylase and lipase increased rapidly, but these enzymes decreased rapidly in urinary excretion and gradually in serum concentration. Urinary recovery of amylase was approximately 10% of the total infused amount of pancreatic juice at the end of 4 hours. 2. Following ligation of the pancreatic duct, the amylase and lipase levels of serum rose gradually and reached the maximum at 24-48 hours after ligation and then gradually fell. The output of these enzymes in the urine were relatively constant while serum enzymes were increased. 3. When the human pancreatic juice was infused, hypotension was pronounced, and it was deeper and more prolonged in hypotensive effect with infusion of highly concentrated juice in the enzyme activities. With human pancreatic juice, a more sustained hypotension occurred than was observed after infusion of canine pancreatic emulsion. As a result of this investigation, it is felt that the hypotension in acute pancreatitis is probably the result of pancreatic enzymes itself. 4. In postinfusion period, the urine volume was markedly decreased following hypotension, and the urine volume was increased following blood pressure to normal level. This suggests that urine volume may diminish resulting from transient acute renal failure due to hypotensive effect by pancreatic enzymes.
Acute Kidney Injury ; Amylases ; Animals ; Blood Pressure ; Blood Volume ; Capillaries ; Diagnosis ; Dogs* ; Femoral Vein ; Humans ; Hypercalcemia ; Hypotension ; Infusions, Intravenous ; Ligation ; Lipase ; Pancreas ; Pancreatic Diseases ; Pancreatic Ducts ; Pancreatic Juice ; Pancreatitis ; Prunus ; Research Personnel ; Rivers ; Trypsin ; Urinary Catheters

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

Recently, the 5-year survival rate of rhabdomyosarcoma has been greatly increased by combining therapy with radical surgery, radiation and chemotherapy. But it still has poor prognosis and there are few case reports of rhabdomyosarcoma of head and neck with long term survival rate. Here, we treated a rhabdomyosarcoma patient with radical surgery, radiation and chemotherpy. The patient visited our hospital in 1990 with a complaint of left facial protruding mass, diplopia and exopthalmos. She was diagnosed as rhabdomyosarcoma involving maxillary sinus and orbit. In september 1990, she received left total maxillectomy and eyeball exentration. After the surgery, we applied a 5000 cGy neutron therapy, 2000 cGy external radiation and 9 cycle pulse, along with VAC chemotherapy. She remains free of disease as of her last follow-up in February 1998.
Diplopia ; Drug Therapy ; Follow-Up Studies ; Head ; Humans ; Maxillary Sinus* ; Neck ; Neutrons ; Orbit* ; Prognosis ; Rhabdomyosarcoma* ; Survival Rate

Purpose: The purpose of this paper is to study the epidemiologic series of Tsutsugamushi disease (TD), also known as scrub typhus in the Republic of Korea (Korea) and Japan. Methods: We investigated raw data of TD outbreaks from the National Notifiable Disease Surveillance System of the Korea Diseases Control and Prevention Agency in Korea, and the National Institute of Infectious Diseases in Japan, 2016 to 2020. Results: There were 36,785 cases of TD with a cumulative infectious rate (CIR) of 14.3 per 100,000 populations in Korea from 2016 to 2020. During the same period in Japan, there were 2,350 cases with a CIR of 0.4. When compared, Korea was much higher than that in Japan (P<0.01). In Korea, more females (60.2% of total cases) were infected than males (39.8%), while there was a significant difference between males (58.8%) and females (41.2%) in Japan, respectively (P<0.01). Conclusion These differences in TD risk factors reflect differences of vectors/hosts, climate, and geographical and cultural characteristics between the two countries. The surveillance of TD, primarily a zoonotic disease, should be continued in order to obtain a better understanding of its current status. Moreover, guidelines for the prevention of TD, and its control measures should be more established.

For Korean dialysis patients, chronic kidney disease-mineral bone disorder is a serious burden because of cardiovascular calcification and mortality. However, recent epidemiologic data have demonstrated that many patients undergoing maintenance hemodialysis are out of the target ranges of serum calcium, phosphorus, and intact parathyroid hormone. Thus, we felt the necessity for the development of practical recommendations to treat abnormal serum phosphorus, calcium, and iPTH in dialysis patients. In this paper, we briefly comment on the measurement of serum calcium, phosphorus, iPTH, dialysate calcium concentration, dietary phosphorus restriction, use of phosphate binders, and medical and surgical options to correct secondary hyperparathyroidism. In particular, for the optimal management of secondary hyperparathyroidism, we suggest a simplified medication adjustment according to certain ranges of serum phosphorus and calcium. Large-scale, well-designed clinical studies are required to support our strategies to control chronic kidney disease-mineral bone disorder in this country. Based on such data, our practice guidelines could be established and better long-term outcomes should be anticipated in our dialysis patients.
Calcium ; Dialysis ; Humans ; Hyperparathyroidism, Secondary ; Kidney* ; Mortality ; Parathyroid Hormone ; Phosphorus ; Phosphorus, Dietary ; Renal Dialysis

PURPOSE: To analyze the clinical features of peripheral neuropathy in Korean children. METHODS: A total of 62 children with acute flaccid paralysis, longstanding weakness of extremities, or abnormal electrophysiological studies, suggestive of peripheral neuropathy, were evaluated retrospectively from the hospital records. The subjects were recruited at the pediatric neurology and endocrine clinic, Kyungpook National University Hospital from 2000 to 2002 and they all went through neurological examination and electrophysiological studies with or without nerve biopsy. RESULTS: Thirty nine children(Male 24:Female 15; Mean age 7.6+/-4.3 years) were found to have clinical peripheral neuropathy. Inflammatory neuropathy(5 children with Guillain Barre syndrome, 1 children with chronic inflammatory demyelinating polyneuropathy, 12 children with Bell's palsy; 46%) was the most common, followed by hereditary neuropathy(4 children, 10%), Chemotherapy induced neuropathy(3 children, 8%), metachromatic leukodystrophy(2 children, 5%), trauma(2 children, 5%), diabetic neuropathy(1 children, 3%) and so on. Thirty two children had motor neuropathy(82%), six children had combined motor and sensory neuropathy(15%), two had pure sensory(5%), but nobody had autonomic neuropathy. With respect to the type of involvement, polyneuropathies constitute 59%(23 children), mononeuropathy simplex accounted for 38%(15 children), mononeuropathy multiplex was found in 3%(1 child). Based on electrophysiological studies and biopsy results, demyelinating neuropathy was seen in 22 children(56%), axonal neuropathy in 12 children(31%), combined neuropathy in 5 children(13%). Eighteen children(46%) were completely or almost completely recovered from the illness. CONCLUSION: Inflammatory neuropathy was the most common among the acquired neuropathies and hereditary motor sensory neuropathy was the most common among the genetic neuropathies. Treatable neuropathies took up 46%. Potentially preventable neuropathies accounted for 36%. Early diagnosis and early intervention may have significant impacts on the prognosis of peripheral neuropathy in children.
Axons ; Bell Palsy ; Biopsy ; Child* ; Drug Therapy ; Early Diagnosis ; Early Intervention (Education) ; Extremities ; Guillain-Barre Syndrome ; Gyeongsangbuk-do ; Hospital Records ; Humans ; Mononeuropathies ; Neurologic Examination ; Neurology ; Paralysis ; Peripheral Nervous System Diseases* ; Polyneuropathies ; Prognosis ; Retrospective Studies

The Korean Agricultural Culture Collection (KACC) has developed a web-based system to provide an integrated database with information updates about microbial resources. This integrated database consists of 5 major functions and contains general information, which includes identification numbers, culture media composition, image information, DNA sequences, patent information, and general forms for ordering and depositing microorganisms. In 2008, KACC started providing characterization information. KACC maintains 9,801 cultures of microorganisms, including 3,296 strains of bacteria, 4,734 fungi, 784 actinomycetes, 64 yeasts, and 923 others.
Actinobacteria ; Bacteria ; Base Sequence ; Culture Media ; Fungi ; Yeasts

The dermatophytosis of the hands is dry, scaly, erythematous macules with well demarcation on the palms and dorsa of hands. However, involvement of fingerwebs without any other affected area of the hands is rare. We report a case of interdigital dermatophytosis caused by Trichophyton (T.) rubrum in a 38-year-old man, who showed fine scaly erythematous macules on the left third fingerweb. Fungal culture from scales of the lesions showed typical white to deep red, cottony colonies of T. rubrum.
Adult ; Hand ; Humans ; Tinea* ; Trichophyton ; Weights and Measures