It is important to recongnize that the finding of Clostridia in a wound does not establish the diagnosis of gas gangrene. Clostridia may be present in traumatic wound under three circumstances: (1) simple contamination, (2) anaerobic cellulitis, and (3) gas gangrene. Confusion between clostridial cellulitis and gas gangrene may be avoided by remembering that clostrdial cellulitis is not associated with muscle invasion, and seldom produce swelling, pain, toxemia, or shock. Authors had been treated a case of clostridial infection with a vascularized groin flap followed by good result.
Cellulitis ; Clostridium perfringens ; Clostridium ; Diagnosis ; Gas Gangrene ; Groin ; Shock ; Toxemia ; Wounds and Injuries

No abstract available.
Brain* ; Schizophrenia ; Tomography, Emission-Computed, Single-Photon*

In the treatment of flexor tendon injury of the hand, re-rupture after primary tendon repair is one of complications which occurs occasionally and so impose burden on both the patient and the surgeon. Authors experienced twelve cases of re-rupture after primary flexor tendon repair of 274 patients from Mar. 1989 to Mar.1996. The incidence of re-rupture after primary flexor tendon repair was 4.4% in author's series. One case happened with slip down injury, and in six cases re-rupture occurred during physical therapy with snapping click sound. However in five cases, the patients conldnt recognize any related causes. In majority of cases, re-ruptures were identified between three and five weeks after primary repair by the surgeon and the patient, so it could be suggested that the attention should be paid for the high possiblity of re-rupture during this period. Operative findings were the resorption and friability of repaired end with insecure suture fixation in two cases, rupture of suture material in four cases and loosening of the knot in six cases. From this study, the authors suggest the importance of knot, and recommend to make more than four knots on suture tie with attention to the tie direction, and advise careful physical therapy according to each patients' different situation. In the treatment of re-rupture, end-to-end re-anastomosis was available in seven cases (59%). In five cases (41%), tendon graft was needed. The clinical result of the re-rupture cases was evaluated by the Stickland evaluation method, and it was satisfactory in 67% of the patients who had the complication of re-rupture.
Hand* ; Humans ; Incidence ; Rupture ; Sutures ; Tendon Injuries ; Tendons* ; Transplants

Eleven cases of the free vascularized bone graft have been performed in the Department of Orthopaedic Surgery, Yonsei University Hospital during the period of 30.9 months from February 1981 to December 1985. Follow up ranges from 8 to 62 months. The indication for the procedure was reconstruction of extensive bony defect after acute trauma in 3 cases, osteomyelitis in 3 cases, chronic nonunion 3 cases, bone tumor in one case and congenital pseudoarthrosis in one case. The results were obtained as follows; 1. To reconstruct the lower extremity the vascularzed bone graft has much more advantages than the other conventional method and the technique may be very useful in the management of certain difficult reconstructive problem of the lower extremity. 2. In the defects of bone and skin, even infected, composite bone and soft tissue transfer can be filled by one stage operation and made the infection heal more rapidly. 3. In children the vacularized fibular graft was hypertrophied and similar to thickness of tibia.
Child ; Follow-Up Studies ; Humans ; Lower Extremity ; Methods ; Osteomyelitis ; Pseudarthrosis ; Skin ; Tibia ; Transplants

No abstract available.
Endocarditis* ; Lupus Erythematosus, Systemic*

No abstract available.
Amniotic Fluid* ; Female ; Humans ; Infant* ; Prospective Studies*

Clinical observation was made on the 16 patients of penile carcinoma admitted to the Department of Urology, Seoul National University Hospital during the period from September, 1967 to August, 1976 and the following results were obtained. 1. The incidence of penile carcinoma was 0.5% of total inpatients of urologic department and 3.5% of male genitourinary tumors. 2. Age distribution was between 29 and 78, snowing highest incidence at 50-59 years. 3. Clinical findings were; mass 77%, discharge 28%, ulcer 25%, bleeding 13%, and inguinal lymphadenopathy 50%. 4. The average duration of the symptoms on admission to hospital was 10 months with the highest incidence in 1 to 6 months. 5. The locations of the tumors were; preputial cavity 87%, confined to glans 6%, penile shaft involved 6%. 6. Treatments were made with partial amputation in 50%, partial amputation with inguinal lymphadenectomy in 37%, and biopsy in 13%.
Age Distribution ; Amputation ; Biopsy ; Hemorrhage ; Humans ; Incidence ; Inpatients ; Lymph Node Excision ; Lymphatic Diseases ; Male ; Penis* ; Seoul ; Snow ; Ulcer ; Urology

No abstract available.
Paragonimiasis*

BACKGROUND: Genus of Aspergilli are ubiquitous saprophytic molds in nature, but its change from a saprophytic fungus to a pathogenic organism has occurred since the use of various antibiotics. The fungus affects the chronically ill and debilitated population. Recently frequency of the fungal infection is increasing in Korea with abuse of antibiotics and glucocorticoids. METHOD: We analyzed medical records of 52 patients with pulmonary aspergillosis seen at Hanyang University Hospital from 1980 to 1994. The results were as follows; RESULTS: 1) Ages ranged between second to eighth decades with majority(50%) in the fourth to fifth decades. The male to female ratio was 1.1:1. 2) Hemoptysis and productive cough, the leading symptoms, occurred in 42.3% and 25% respectively. 3) On chest X-ray fingings, the characteristic 'fungus ball' pattern were observed in 53.8% of the 52 cases. 4) Sputum culture for aspergilli were positive in 21.6% of the cases. We performed foe needle aspiration in 22 patients and the diagnostic yield was 100%. 5) Thirty-six patients had history of treatment with antituberculous drugs under diagnosis of pulmonary tuberculosis for an average of 27.3 months. But sputum analysis for acid-fast bacilli were positive in 5.6%(2cases of 36cases), and postoperative pathologic findings showed that 38.9% (12 cases of 28cases) were combined with tuberculosis. 6) Right upper and left upper lobes were predominantly involved(34.6% and 19.2% respectively) and lobectomies were performed in 21 cases. 7) Underlying diseases were present in 47 cases and 48.9% of them were pulmonary tuberculosis. CONCLUSION: These results showed that pulmonary aspergillosis usually develops in patients with open cavitary pulmonary tuberculosis. And we must consider the possibility of pulmonary aspergillosis in a patient with hemoptysis and cavitary lung lesion.
Anti-Bacterial Agents ; Aspergillus ; Chronic Disease ; Cough ; Diagnosis ; Female ; Fungi ; Glucocorticoids ; Hemoptysis ; Humans ; Korea ; Lung ; Male ; Medical Records ; Needles ; Pulmonary Aspergillosis* ; Sputum ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary

No abstract available.