Purpose: Diabetic foot ulcers and gangrene are major complications of diabetes, often accompanied by peripheral vascular occlusion.Revascularization is performed to restore blood flow and reduce complications such as amputation surgery. Nevertheless, reocclusion, a frequently reported complication after revascularization, often necessitates further lower limb amputations to facilitate rehabilitation and ambulation. This study examined the factors influencing the performance of secondary revascularization procedures in patients with diabetic foot gangrene who even underwent transtibial amputation (TTA) following revascularization. Materials and Methods: A retrospective study was conducted on 36 patients with diabetic foot gangrene who underwent TTA after revascularization from March 2005 to March 2022. The factors influencing restenosis were classified into three categories: revascularization factors, preoperative factors, and intraoperative factors. The revascularization factors were categorized based on whether percutaneous transluminal angioplasty (PTA) or bypass surgery had been performed. Preoperative factors included the patient’s age, gender, body mass index (BMI), hypertension, and other relevant factors. Intraoperative factors included surgery duration, blood loss, and transfusion. The study examined the factors influencing secondary revascularization in these three categories. Results: Among the 36 patients in the study, 27.8% (11 patients) underwent secondary revascularization procedures. There was no significant correlation between the performance of secondary revascularization and the type of revascularization procedure, whether PTA or bypass surgery (p>0.05). Similarly, no significant differences were observed in preoperative factors (including age, BMI, smoking status, HbA1c, and underlying diseases) and intraoperative factors (surgery duration, blood loss, and transfusion). On the other hand, regarding gender, all patients who underwent revascularization procedures were male, indicating a statistically significant result (p=0.039). Conclusion This study suggests that while most clinical variables showed no association with reocclusion, the fact that all patients who underwent secondary revascularization procedures were male indicates that gender may be a significant predictive factor of revascularization.

BACKGROUND: Epidermal grafting using cryotherapy for recipient sites is in widespread use. However the peripheral hypopigmented haloes that occur around the recipient sites require prolon gation of the treatment period. OBJECTIVE: We used a CO2 laser to remove the epidermis of the recipient sites for betteri results. METHODS: We treated lie localized vitiligo patients with CO2 laser to remove t.he epidermis and grafted suction blister rooves. We observed repigmentation and complications 1 month later. RESULTS & CONCLUSIONS : The superiority of this method is demonstrated by the fact 1) all prodedures can be completed on the day of operation 2) the incidence of hypertrophic scar and peripheral hypopigmented halos can be observed.The problems of this method are 1) uneven repigmentation of recipient. sites 2) hyperpigrnentation of recipient sites
Blister ; Cicatrix, Hypertrophic ; Cryotherapy ; Epidermis* ; Humans ; Incidence ; Lasers, Gas* ; Suction ; Transplants* ; Vitiligo*

Between August 1994 and June 1995, seventeen patients diagnosed as having partial or complete ruptures of the anterior cruciate ligament on MRI were managed by non-operative methods. Among them four patients were excluded due to operation during follow-up and the results were evaluated at a one year follow-up. We selected the patients prospectively for non-operative care using the selection criteria of age, degree of instability, activity level and patient compliance. The average age of them was 37.7 years. Initially knee stress test and MRI were checked, and Cybex study and Lysholm knee scoring were done at post-trauma one year follow-up. They were managed conservatively by ROM and muscle strengthening exercises and a brace fitting schedule for three months. Among them, six cases had partial tears and seven had a complete tear initially. At the one year follow-up, five of six cases who had shown partial ruptures, and two of seven cases with complete tears, recovered continuity of the ruptured ACL on MRI. Their Lysholm knee score was 84.4, and the Cybex test showed no difference in muscle power between the injured and uninjuried side. Those patients who had loss of continuity on follow-up MRI showed Lysholm score of 57.4 and decreased muscle power on Cybex study. Although there are still controversies about the adequate management of ACL injuries, our study suggests that conservative management is a viable alternative to surgery as long as the patients are selected prudently. For more concrete results, however, careful analysis based on a longer follow up period is necessary.
Anterior Cruciate Ligament* ; Appointments and Schedules ; Braces ; Exercise ; Exercise Test ; Follow-Up Studies ; Humans ; Knee ; Magnetic Resonance Imaging ; Patient Compliance ; Patient Selection ; Prospective Studies ; Rupture*

In certain low-grade malignant tumors such as chondrosarcoma and giant cell tumor, radical treatments may provide a good chance for cure. And large bony defect after the radical treatment can be filled with the massive bone graft. Recent advances in clinical microsurgery have made free tissue transfer a clinical reality, and Taylor in 1975, first reported the technique of free vascularized fibula graft for the reconstruction of large tibial defects with excellent clinical results. We tried wide excision and free vascularized bone graft in 6 patients with malignant or aggressive bone tumor from April 1981 to November 1985 and followed up for more one year. Mean follow up of free vascularized bone graft is 26.4 months and that of devascularized bone graft is 22.6 months. The results of the free vascularized bone graft were compared with 10 patients who were treated with the wide excision and the devascularized bone graft. In this analysis, free vascularized bone graft is superior to devascularized bone graft in bony union, complications and functional results.
Chondrosarcoma ; Fibula ; Follow-Up Studies ; Giant Cell Tumors ; Humans ; Microsurgery ; Transplants

Upper extremity deep vein thrombosis (DVT) is an unusual condition compared to lower extremity DVT, and it represents about 10% of all DVTs. We report a case of upper extremity DVT after clavicle fracture and immobilization.

The purpose of this study was to evaluate the clinical efficacy of guided tissue regeneration(GTR) technique using chitosan nanofiber membrane and to compare it to the clinical efficacy following GTR using PLA/PLGA(copolymer of polylactic acid and polylacticglycolic acid) membrane in mandibular class II furcation defects in human. The chitosan nanofiber membranes were applied to the mandibular class II furcation defects of 13 patients(test group) and PLA/PLGA membranes were applied to those of 11 patients(control group). Probing pocket depth, clinical attachment level, gingival recession, plaque index and gingival index were measured at baseline and 3 months postoperatively. Vertical and horizontal furcation defect depth were measured at surgery. Both groups were statistically analyzed by Wilcoxon signed Ranks Test and Mann-Whitney Test using SPSS program. The results were as follows: 1. Probing pocket depth, clinical attachment loss and gingival index were significantly reduced at 3 months postoperatively compared to values of baseline in both groups(p<0.05). 2. Gingival recession and plaque index were not significantly decreased at 3 months postoperatively compared to values of baseline in both groups. 3. No significant difference between two groups could be detected with regard to changes of probing pocket depth, gingival recession, clinical attachment level, plaque index and gingival index at 3 months postoperatively. In conclusion, chitosan nanofiber membrane is effective in the treatment of human mandibular class II furcation defects and a longer period study is needed to fully evaluate the outcomes.
Humans

The purpose of this study was to evaluate the clinical efficacy of guided tissue regeneration(GTR) technique using chitosan nanofiber membrane and to compare it to the clinical efficacy following GTR using PLA/PLGA(copolymer of polylactic acid and polylacticglycolic acid) membrane in mandibular class II furcation defects in human. The chitosan nanofiber membranes were applied to the mandibular class II furcation defects of 13 patients(test group) and PLA/PLGA membranes were applied to those of 11 patients(control group). Probing pocket depth, clinical attachment level, gingival recession, plaque index and gingival index were measured at baseline and 3 months postoperatively. Vertical and horizontal furcation defect depth were measured at surgery. Both groups were statistically analyzed by Wilcoxon signed Ranks Test and Mann-Whitney Test using SPSS program. The results were as follows: 1. Probing pocket depth, clinical attachment loss and gingival index were significantly reduced at 3 months postoperatively compared to values of baseline in both groups(p<0.05). 2. Gingival recession and plaque index were not significantly decreased at 3 months postoperatively compared to values of baseline in both groups. 3. No significant difference between two groups could be detected with regard to changes of probing pocket depth, gingival recession, clinical attachment level, plaque index and gingival index at 3 months postoperatively. In conclusion, chitosan nanofiber membrane is effective in the treatment of human mandibular class II furcation defects and a longer period study is needed to fully evaluate the outcomes.
Humans

BACKGROUND: Hepatitis B is a leading cause of chronic hepatitis, cirrhosis, and hepatocelluar carcinoma. It is a well-known fact that Korea is one of the hyperenedemic areas of Hepatitis B virus among East Asian countries. Many pnst reports have shown that positive rate of HBsAg in Korea was about 6-14%. But precise data for Yongdong area of Kwangwon Province in Korea was lacking. Here authors report on the prevalence of viral markers of hepatitis B among adults in this area. method: Sera were collected from 7469 residents in Yongdong area of Kwangwon Province who visited the Health Care Center, Asan Kangnung Hospital from September 11th to August 31th. HBsAg, AntiHBc-IgG, and AntiHBs were tested by radioimmunoassay. RESULTS: Positive rate of HBsAg of total study subjects was 8.5%, and was significantly decreased as age increased, and higher in males(10.2%) than in females(6.6%). Positive rate for one or more markers among HBsAg, AntiHBc-IgG, and AntiHBs was 84%, and was significantly increased as age increased, and higher in males(86.2%) than in females(81.2%). All negative rate for HBsAg, AntiHBc-IgG, and AntiHBs was 16.0% and all positive rate was 0.5%. Positive rate of AntiHBc-IgG without HBsAg and AntiHBs was 15.7% Positive rate of AntiHBs without HBsAg and AntiHBc-IgG was 11.7%. Positive rate of AntiHBc-IgG and AntiHBs was 72.1% and 60.2%, respectively. CONCLUSIONS: There was no significant difference in positive rate of HBsAg between this study for residents in Yongdong area of Kwangwon Province and past many reports. 84% of the total study subjects showed serological evidence of previous exposure to hepatitis B virus (HBV) naturally exposed or by vaccine immunization. 16% of the total study subjects was a proper candidate for hepatitis B vaccination.
Adult* ; Asian Continental Ancestry Group ; Biomarkers ; Chungcheongnam-do ; Delivery of Health Care ; Epidemiology ; Fibrosis ; Gangwon-do* ; Hepatitis B Surface Antigens ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis* ; Hepatitis, Chronic ; Humans ; Immunization ; Korea ; Prevalence ; Radioimmunoassay ; Seroepidemiologic Studies* ; Vaccination

BACKGROUND: Pulmonary tuberculosis(TB) is still prevalent and remains a significant clinical problem for the elderly. However, the disease presents in many ways, and there are frequent adverse drug reactions that may prevent the early diagnosis and treatment of elderly TB patients compared to the young. The purpose of this study was to determine whether or not there are any differences in the clinical feature of pulmonary tuberculosis(TB) in both the diagnosis and treatment between the young (less than 64 years) and the elderly (65 years and more). METHODS: The medical records of 125 young and 70 elderly pulmonary TB patients, who were diagnosed with and treated for pulmonary TB at the Seoul Municipal Boramae Hospital from November 1991 to January 1997, were analyzed retrospectively. RESULTS: Anorexia(12% vs. 31.4%), general weakness (20.0% vs. 54.3%), dyspnea(21.6% vs. 37.1%) and an abnormal mentality (0.8% vs. 15.7%) were more frequent presenting symptoms in elderly TB patients, whereas hemoptysis (32.8% vs. 10.0%) and fever (BT>37℃ 58.4% vs. 35.7%) were more frequent in the young. The elderly had a higher number of cardiovascular and chronic obstructive pulmonary diseases as underlying illnesses. In chest PA, there were no differences in the location of the TB lesion, but the appearances were initially diagnosed more frequently as pneumonia or lung cancer (8.8% vs. 30.0%, p<0.05) in the elderly. There was no difference in the detection rate of acid fast bacilli(AFB) in the sputum between the two groups. There were no differences in the treatment response and follow-up loss. However, adverse drug reactions (13.6% vs. 45.7%, p<0.05), and changes in medication (4.9% vs. 25.7%, p<0.05) during treatment occurred more frequently in the elderly. One among the 125 young patients died from tuberculosis whereas 6 among the 70 elderly patients died from the disease. CONCLUSION: Because the clinical and radiological presentations were more atypical, a sputum AFB smear and culture should be done immediately in the elderly who are TB. The elderly experienced more frequent adverse drug reactions and mortality during treatment, but the response to treatment was good and rapid.
Aged* ; Diagnosis ; Drug-Related Side Effects and Adverse Reactions ; Early Diagnosis ; Fever ; Follow-Up Studies ; Hemoptysis ; Humans ; Lung Diseases, Obstructive ; Lung Neoplasms ; Medical Records ; Mortality ; Pneumonia ; Retrospective Studies ; Seoul ; Sputum ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary*

In Korea, every worker should undergo a preemployment medical examination according to Law for Occupational Safety and Health. But evaluation of it has not been previously carried out. Thus a telephone survey of 213 establishments of Inchon area for evaluation of preemployment medical examination in Korea was conducted. One hundred and fourteen companies(46.5% of all the subjects) were examined medically on preemployment, 47 establishments(41.2% of this study subjects) reevaluated workers by each establishment's medical criteria, and only less than half of diseased workers(DM 38.6% ; hypertension 42.1%, HBV carrier 28.0 % ; active pulmonary tuberculosis 7.9 %; back pain 12.3 %, and noise induced hearing loss 18.4 %) were employed. Employee's fees for preemployment medical examination were covered by 53.5 % of all the subjects. From our survey, it is clear that preemployment medical examination plays discriminating role on the employment of workers based on health status. We thus proposed to change over from preemployment medical examination to preplacement examination based on the evaluation of essential job functions and reasonable accommodation.
Back Pain ; Employment ; Fees and Charges ; Hearing Loss ; Hypertension ; Incheon ; Jurisprudence ; Korea* ; Noise ; Occupational Health ; Telephone ; Tuberculosis, Pulmonary