Necrotizing fasciitis (NF) is an aggressive soft-tissue infection involving the deep fascia and is characterized by extensive deterioration of the surrounding tissue. Immediate diagnosis and intensive treatment, including debridement and systemic antibiotics, represent the most important factors influencing the survival of NF patients. In this report, we present a case of NF in the abdomen due to an infection caused by a perforated small bowel after abdominal liposuction. It was successfully treated using negative-pressure wound therapy, in which a silicone sheet functioned as a barrier between the sponge and internal organs to protect the small bowel.
Abdomen ; Abdominal Wall* ; Anti-Bacterial Agents ; Debridement ; Diagnosis ; Fascia ; Fasciitis, Necrotizing* ; Humans ; Lipectomy ; Negative-Pressure Wound Therapy* ; Peritoneum ; Porifera ; Silicon* ; Silicones*

PURPOSE: This study was to evaluate the effects of Aloe, Gelfoam, and Plaster of Paris on bone healing. MATERIALS AND METHODS: Four experimental defects were created for placement of the three materials in the right femur of dogs. One defect served as an empty control site. The evaluation was performed at 1-, 6-, and 12-weeks by light microscopy and NIH image program. RESULTS: Radiographic and Histologic examinations showed new bone formation in the presence of Aloe, Gelfoam, and Plaster of Paris and similar bone healing reactions. CONCLUSION: On the basis of these findings, it was concluded that Aloe, Gelfoam, and Plaster of Paris may be adequate agents for use in bone procurement.
Aloe* ; Animals ; Calcium Sulfate ; Dogs ; Femur ; Gelatin Sponge, Absorbable* ; Microscopy ; Osteogenesis*

Fetal bilateral renal agenesis is a lethal congenital anomaly. An early and reliable prenatal diagnosis is extremely important as it may offer options for pregnancy termination as early as possible. The criteria for the ultrasonographic diagnosis of bilateral renal agenesis are severe oligohydramnios, nonvisualization of the bladder, and the empty renal fossa. However, severe oligohydramnios makes it difficult to diagnose the disease because of poor sonographic resolution. We present two cases of bilateral renal agenesis, one is diagnosed by ultrasonography after amnioinfusion at 24 weeks gestation, the other is diagnosed postnatally after term delivery.
Diagnosis ; Female ; Oligohydramnios ; Pregnancy ; Prenatal Diagnosis ; Ultrasonography ; Urinary Bladder

The antihypertensive effect of Doxazocin were evaluated in 20 patients with essential hypertension. Two to eight mg of Doxazocin per day were administered continuously for two or eight weeks. The results were as follows : 1) Doxazocin were effective in 18 out of 20 patients(90%) at the end of 8 weeks treatment. 2) The systolic blood pressure was signigicantly decreased(173+/-20mmHg VS 144+/-33mmHg, P+/-0.001), and the diastolic blood pressure was also decreased(110+/-10mmHg VS 93+/-19mmHg, P<0.01) after treatment. 3) Triglyceride showed a decreasing tendency but statistically significance was not observed. Total cholesteral, HDL-cholesterol, BUN, creatinine, and uric acid did not change significantly before and after treatment with Doxazocin. 4) The side effects were headache in one case and dizziness in to cases. These results suggest that Doxazocin is an effective antihypertensive agent and concerning lipid profile, further long term observation is needed.
Blood Pressure ; Creatinine ; Dizziness ; Headache ; Humans ; Hypertension* ; Triglycerides ; Uric Acid

Time intervals and indices of left ventricular diastolic filling were studied by M-mode and pulsed Doppler Echocardiography in 18 dilated cardiomyopathy patients. After one two hours captopril(capril(R)) 25mg medication. 1)Systolic blood pressure, Diastolic blood pressure, Heart rate were significantly decreased. 2) Dimensions of LVSD, LVDD, LA, Aorta and EF were not changed measured by M-mode echocardiography. 3) IRT measured by M-mode and Pulsed Doppler echocardiography were significantly increased(45+/-33msec VS 74+/-35msec. 84+/-32msec VS 100+/-22msec P<0.05). 4) A2-E measured by M-mode and Pulsed Doppler echocardiography were significantly increased(114+/-45msec VS 134+/-46msec, 156+/-46msec VS 194+/-48msec, P<0.05). 5) Deceleration time was significantly increased(137+/-36msec VS 205+/-40msec P<0.05). 6) Transmitral peak flow velocities were not changed significantly. In summary captopril influences early diastolic time intervals with dilated cardiomyopathy patients and we interpreted these effects be beneficial on diastolic filling pattern.
Aorta ; Blood Pressure ; Captopril ; Cardiomyopathy, Dilated* ; Deceleration ; Echocardiography ; Echocardiography, Doppler, Pulsed ; Heart Rate ; Humans

Candida albicans infections of the spine are relatively uncommon in spite of the increasing frequency of predisposing factors. Moreover, late onset spondylodiscitis after bloodstream candidiasis is extremely rare. A 66-year-old woman to have been underwent chemotherapy was diagnosed with candidemia. Antifungal agent was administrated until two weeks after no detection of fungus in the blood culture. The chemotherapy was continued. But, she was hospitalized due to abdominal pain and diarrhea. Pseudomembranous colitis was diagnosed. After metronidazole administration, she was improved and discharged. However, she revisited because of back pain and fever. Spondylitis and discitis on the 10th~11th thoracic spine was shown in magnetic resonance images. Open curettage and spinal stabilization was performed. C. albicans was identified. Antifungal agent was administrated and the patient improved well postoperatively. We present a rare case of late onset Candida spondylodiscitis after candidemia with review of the literatures.

BACKGROUND: It has been reported that estrogen receptor beta (ERbeta) mRNA expression was down-regulated during carcinogenesis and was inversely related to estrogen receptor alpha (ERalpha) expression in breast cancer. The association of ERbeta mRNA expression to tamoxifen resistance has also been reported. In this study, the expression of ERalpha and ERbeta via immunohistochemistry (IHC) and reverse transcription-polymerase chain reaction (RT-PCR) was prompted, and an attempt was made to find out the relationship between ERbeta expression and recurrence in the hormonal therapy group, and between ERbeta expression and known prognostic factors. METHODS: Tumor specimens were obtained at surgery from 67 female breast cancer patients during the period of September 1995 to December 2000. All the specimens were frozen in liquid nitrogen and kept at -70degrees C until they were used. The medical records were analyzed retrospectively. The expressions of ER were analyzed using IHC and RT-PCR methods. RESULTS: The median follow-up was at 93.0 months (range: 14-157 months). The percentage of ERalpha+/ERbeta+, ERalpha+/ERbeta-, ERalpha-/ERbeta+, and ERalpha-/ERbeta group were 35.9% 9.4%, 47.2%, and 7.5%, respectively, in 53 patients with hormonal therapy. ERbeta was positive in 42 (82.3%) of 51 ER-positive patients. In the hormonal therapy group, the recurrence rates of each group was 15.8%, 0%, 40.0%, and 0%, respectively. In this group, the ERbeta expression tended to recur, but there was no clinical significance (p=0.084). CONCLUSION: The ERbeta expression may be a predictive marker of a poor response to endocrine therapy in breast cancer patients, although this needs to be confirmed in additional studies.
Breast ; Breast Neoplasms ; Estrogen Receptor alpha ; Estrogen Receptor beta ; Estrogens ; Female ; Follow-Up Studies ; Humans ; Immunohistochemistry ; Medical Records ; Nitrogen ; Recurrence ; Retrospective Studies ; RNA, Messenger ; Tamoxifen

PURPOSE: To compare the corneal power (K) measured by different methods in the patients who underwent photorefractive keratectomy (PRK) or laser in situ keratomilieusis (LASIK) METHODS: Fifty-four patients who had undergone PRK or LASIK from December 1999 to December 2000 and followed for 3 months or longer were selected for this study. The corneal power was measured by five different methods in 35 eyes(18 patients) of PRK group and in 70 eyes (36 patients) of LASIK group: calculation method (C-K), hard contact lens method (H-K), autorefractokeratometer (A-K), manual keratometer (M-K) and topography (T-K). RESULTS: Preoperative mean corneal power was 43.41+/-1.06 D in PRK group and 43.75+/-1.03 D in LASIK group. Postoperative corneal power in PRK group showed following Results: C-K, 40.94+/-1.51 D; H-K, 41.04+/-1.23 D; A-K, 41.18+/-1.29 D; M-K, 41.38+/-1.33 D; T-K, 41.67+/-1.26 D. In LASIK group, the results were: C-K, 38.64+/-2.25 D; H-K, 39.29+/-1.66 D; A-K, 39.53+/-1.61 D; M-K, 39.85+/-1.54 D; T-K, 40.36+/-1.26 D. The corneal power of calculation method was lowest in both groups. Each corneal power was not different statistically from the others in PRK group(p=0.16). However, C-K was significantly lower than A-K (p=0.02), M-K (p=0.00) or T-K (p=0.00) in LASIK group. Also, H-K or AK was lower than T-K statistically in LASIK group (p=0.00, p=0.02). CONCLUSIONS: The corneal power was lowest when measured by calculation method after refractive surgery. In LASIK group, there were statistical differences among the corneal powers by each method.
Humans ; Keratomileusis, Laser In Situ ; Photorefractive Keratectomy ; Refractive Surgical Procedures*

Airway Management ; Aorta ; Drainage ; Edema ; Esophagus ; Heart ; Lung ; Mediastinitis ; Mediastinum ; Neck ; Thorax ; Tongue ; Vagus Nerve

Background: The purpose of this study was to identify factors inhibiting access of people with disability to health check-ups as well as identify pertinent solutions for improvement. Methods: Twenty-three people with disability older than the age of 19 who took respective health check-ups within the last 3 years were selected as participants. For the data collection, the 1:1 intensive interview was used. The data were analyzed by the grounded theory by Corbin and Strauss. Results: The results comprised nine categories, 23 subcategories, and 179 concepts. The central phenomenon was ‘failure to obtain check-ups.’ Causal conditions were observed as a ‘lack of communication method,’ ‘physical difficulties,’ and ‘staff unfamiliar with people with disability,’ Interventional conditions comprised ‘physical accessibility,’ ‘staffs’ competency,’ and ‘assistant manpower.’ The active strategy was included ‘to investigate the professional medical institution,’ ‘to find the medical institution of convenient traffic accessibility,’ ‘to overcome communication difficulties through equipment,’ and ‘to overcome linguistic barriers through sufficient communication.’ Whereas, ‘utilization of ancillary equipment,’ ‘the education of staffs on people with disability,’ ‘universal design manual,’ and ‘customized check-ups’ were included in the passive strategy. Such processes arose in the contextual conditions of ‘lack of expectations for daily lives’ and ‘lack of government support.’ As a consequence, the subjects participated experienced the ‘disadvantages,’ ‘discrimination,’ and ‘reduced reliability of the health check-ups.’ Conclusion The subjects who participated in this study emphasized ‘staffs familiar with people with disability’ and ‘systems customized for people with disability’ are mandatory to secure complete health check-ups for people with disability.