Sporotrichosis is an infection of worldwide distribution caused by the fungal organiam sporotrichum schenckii. The disease is usually of the primary cutaneous variety with involvement of regionaI lymphatics, although dissemination may occur. A case of lymphatic type of Syorotrichosis affecting 33 years old, barber, who has been suffering from painless multiple nodules on right hand 4 forearm, is presented. The skin lesions developed about 3months ago, and increased sise and numbers of the lesion insidiously. Diagnosis was confirmed by characterietic clinical, mycological, histopathological studies He was treated with potassium iodide and there was markedly improved.
Adult ; Diagnosis ; Forearm ; Hand ; Humans ; Potassium Iodide ; Skin ; Sporothrix ; Sporotrichosis*

Fournier's gangrene is an infective necrotizing fasciitis of the perineal, genital or perianal regions. Management of this disease has involved prompt surgical debridement with initiation of broad spectrum antibiotics and intensive supportive care. Multiple debridements orchiectomy, urinary deversion, and fecal diversion should be performed as clinically indicated. Hyperbaric oxygen therapy and topical application of unprocessed honey may prove to be useful adjuncts as new therapies. After excision of all necrotic tissue, the tissue losses have been managed by primary repair. split-thickness skin grafts, rotational or free myocutaneous flaps and omental flaps. Skin graft did not take on bare testis lacking the tunica vaginalis, and gracilis myocutanous flap was too bulky to cover the scrotal area. The progress of necrosis ceased by using intravenous PGE1 injection in the aspect of characteristic obliterative endarteritis causing cutaneous and subcutaneous vascular thrombosis and necrosis of tissue in Fournier's gangrene. We have reconstructed large scrotal defects with bilateral superomedial thigh flap in three Fournier's gangrene patients after stopping tissue necrosis with PEG1 treatment and several surgical debridements of the wounds. The use of this flap ensures a virtually normal sensation, which is important for the erotic propensity of the scrotum. Easy flap design and dissection, as well as primary closure of the donor site, are another benefits of this method.
Alprostadil* ; Anti-Bacterial Agents ; Debridement ; Endarteritis ; Fasciitis, Necrotizing ; Fournier Gangrene* ; Honey ; Humans ; Hyperbaric Oxygenation ; Myocutaneous Flap ; Necrosis ; Orchiectomy ; Scrotum ; Sensation ; Skin ; Testis ; Thigh* ; Thrombosis ; Tissue Donors ; Transplants ; Wounds and Injuries

Most of the peripheral nerve injuries from crushing or compressive forces are accompanied by surrounding soft tissue injuries. As a result, poor vascularity due to fibrosis and sacr formation compromises regeneration of the grafted nerve. Vascularized nerve graft shows superior regeneration to that of a non-vascularized one. However, the human body provides few donor sites of vascularized nerve graft clinically. We presumed that the prefabricated myoneural or adiponeural flap, which include fabricated nerves wrapped with surrounding vascularized muscle or adipose tissue flap, influences superiorly on the regeneration of grafted nerve because that surrounding vasculatity indirectly enhances the vascularity of the grafted nerve itself. Thirty adult male Sprague-Dawley rats were divided into three groups: 1) conventional reversed autogenous graft of the femoral nerve alone(n=10); 2) nerve graft entubulated with abdominal adipose tissue flap with a pedicle of inferior epigastric artery(n=10); 3) nerve graft entubulated with adductor muscle flap with a pedicle of the first muscular branch of the femoral artery(n=10). At three months postoperatively, grafted nerves were examined by electrophysiologic study to check amplitudes and motor nerve conduction velocities, as well as histopathologic study for evaluation of regenerated nerve cells, fibrosis and neo-vascularization. Consquently, nerve regeneration was found in all three groups. Both the myoneural and adiponeural flap groups had better improved results of nerve regeneration compared to that of the conventional nerve graft group. The result of myoneural flap group was superior to that of the adiponeural flap group. The myoneural flap group showed minimal fibrosis and less prominent neovascularization around moderately regenerated nerves. The adiponeural flap group showed more severe perineural and endoneural fibrosis, as well as vascular proliferation around focal regenerated nerves. The results of myoneural flap group proved to be statistically significant. We concluded that it is possible to use nerve graft entubulated with a vascularized muscle flap (myoneural flap) as a substitute for vascularized nerve graft.
Abdominal Fat ; Adipose Tissue ; Adult ; Femoral Nerve ; Fibrosis ; Human Body ; Humans ; Male ; Nerve Regeneration* ; Neural Conduction ; Neurons ; Peripheral Nerve Injuries ; Rats, Sprague-Dawley ; Regeneration ; Soft Tissue Injuries ; Tissue Donors ; Transplants*

A total of 100 Vibrio spp. strains were examined for production of various extracellular enzyme and for plasmid content plasmid were subjected to digestion with restriction enzymes. Most of them produced extracellular enzyme more than one, especially V. parahaemolyticus and V. cholerae non-01 strains were showed production of various extracellular enzymes. About the 55% Vibrio spp. have the plasmid more than one, but a lot of Vibrio spp. (about 45%) did not possess any plasmid. Most of these plasmid various derivatives ranged from 2.4 kb-23 kb, especially two strains of V. mimicus and one strain of V. furnissii carried one high-molecular weight plasmid (molecular weight ranging between 70 kb-100 kb). Results of restriction analysis for plasmid of this three strains were by no means the rule. For detection of tdh and ctx gene, the virulence factor involved in the pathogenesis, we carried out the TDH, CT assay, PCR amplification, and hybridization. A total 11 strains were produced TDH, involved in 4 strains of V. parahaemolyticus and 1 strain of V. cholerae non-01 from clinical isolates and 6 strains of environmental isolates. Nine strains of 11 strains, involved in 4 strains of V. parahaemolyticus and 1 strain of V. cholerae non-01 from clinical isolates and 4 strains of V. parahaemolyticus from environmental isolates, could be successfully amplified in 400 bp by PCR, no amplification products were obtained from TDH-negative strains. The PCR results were consistent with DNA hybridization. In the experiments of ctx gene detection, in all, 3 strains of V. cholerae non-01 from clinical isolate and 1 strains of V. cholerae non-01 from environmental isolate were observed CT- positive. These CT-producing strains amplified in 302 bp by PCR for the detection of ctx gene. All CT-producing strains hybridized with digoxigenin-labeled DNA probe, while CT-negative strains did not hybridize. Also hybridization tests results for detection of ctx gene consistent with PCR.
Cholera ; Digestion ; DNA ; Plasmids ; Polymerase Chain Reaction ; Vibrio* ; Virulence Factors* ; Virulence*

To study bone resorption mechanism, effect of LPS on the 45Ca release from fetal rat ulnae and radii, and effects of carbonic anhydrase inhibitors on the LPS-induced bone resorption in organ culture were studied. Ulnae and radii were removed from 19 day old fetal rats, prelabelled by subcutaneous injection of 200micronCi 45CaCl2 into their mother on the 17th day of gestation. Radioactivities of 45Ca released into media were determined after 24, 48 and 72 hours. Effects of LPS and carbonic anhydrase inhibitors were observed by the ratio of % release of 45Ca between paired control and experimental group. The observed results were as follows: 1. LPS(1microng/ml) supplemented in media for 72hours increased the 45Ca release significantly after 48 and 72 hours of culture and LPS(10microng/ml) increased the 45Ca release significantly after 72 hours of culture. 2. LPS-induced 45Ca release was not inhibited significantly by 1mM sulfanilamide but inhibited significantly by 10mM sulfanilamide after 48 and 72 hours of culture. 3. LPS-induced 45Ca release was not inhibited significantly by 0.1mM dichlorphenamide but inhibited significantly by 1mM dichlorphenamide after 48 and 72 hours of culture. 4. LPS-induced 45Ca release was not inhibited significantly by 1mM acetazolamide but inhibited significantly by 5mM acetazolamide after 72 hours of culture.
Acetazolamide ; Animals ; Bone Resorption* ; Carbon* ; Carbonic Anhydrase Inhibitors* ; Carbonic Anhydrases* ; Dichlorphenamide ; Humans ; Injections, Subcutaneous ; Mothers ; Organ Culture Techniques ; Pregnancy ; Radioactivity ; Rats ; Ulna

An association study with Korean alcoholic patients(n=50) and normal controls(n=53) was performed to find the relationship between catechol-O-methyltransferase(COMT) gene polymorphism and alcoholism using polymerase chain reaction-restriction fragment length polymorphism. When we compared the allele and genotype frequencies of Nla III COMT gene polymorphism in alcoholism and normal controls, there was no significant difference between two groups. Our results do not support an association between the Nla III polymorphism of COMT gene and alcoholism.
Alcoholics ; Alcoholism* ; Alleles ; Genotype ; Humans

Hemodialysis patients with chronic kidney disease exhibit impaired exercise tolerance and functional decline. Despite the life-saving benefits of adequate dialysis, those declines translate into frailty and deteriorating quality of life (QoL). This study evaluated the effects of an intradialytic aerobic exercise program on frailty, dialysis adequacy, and QoL among hemodialysis patients. Methods: Patients at an university hospital-affiliated hemodialysis center were randomly assigned to an exercise group (n = 18) or a control group (n = 21). The 12-week aerobic exercise program comprised 40 to 70 minutes of ergometer cycling 3 times/wk and a single education session. The control group completed only the education session. Outcomes were assessed at the time of enrollment, week 4, week 8, and week 12 using Fried’s frailty phenotype measures (gait speed, grip strength, vitality, body mass index, and physical activity), the short physical performance battery (SPPB), Kt/V urea, and the Short Form-36 questionnaire. Results: There were significant interactions between groups and follow-up times in the frailty score (p < 0.001), gait speed (p < 0.001), SPPB (p < 0.001), and mental QoL (p = 0.03). The intention-to-treat and per-protocol analyses revealed that the exercise group exhibited significant improvements in frailty score (p < 0.001), gait speed (p < 0.001), grip strength (p < 0.001), exhaustion (p = 0.02), SPPB (p = 0.01), dialysis adequacy (p = 0.01), and physical QoL (p = 0.003). Conclusion: An intradialytic aerobic exercise program could be a safe, feasible, and appropriate additional strategy to routine care among hemodialysis patients for improvements in frailty, dialysis adequacy, and QoL.

PURPOSE: Male breast cancer is a rare type of neoplasm, account for 1 % of all breast tumors. A retrospective review of the clinical and histological characteristics, types of treatment, pathological staging, and adjuvant treatment was completed. The objective of this study was to make an early diagnosis of male breast cancer and reduce the mortality. METHODS: Over a 5-year period, from Oct. 1994 to July 2000, 10 male breast cancer patients were operated on in the breast cancer clinic of the Samsung Medical Center. Their duration of follow up ranged from 6 to 76 months with a mean of 26 months. The clinical and histological characteristics, associations of the risk factors, type of treatment, and results were studied. RESULTS: Their ages ranged from 40 to 67 years with a mean of 51 years, with 5, 3 and 2 cases in their 5th, 6th, and 7th decades, respectively. A palpable breast lump was the most common presenting symptom. A pathological assessment disclosed 8 infiltrating ductal carcinoma, 1 ductal carcinoma in situ, and 1 invasive adenoid cystic carcinoma. The tumor sizes ranged from 0.5 to 3.7 cm (median, 1.9 cm in diameter). Of the 10 patients, there were 3 T1b, 3 T1c, and 4 T2 in the tumor staging. 4 Patients had axillary node involvement (lymph node positivity, 40%), and of these 4, the metastasis involved 2 lymph nodes and more than 3 lymph nodes in 1 and 3 case, respectively. No distant metastasis was observed in any of the patients. Pathological stages of the patients 0, I, IIIA, and IIIB in 1, 5, 1 and 2 cases, respectively. All the patients underwent surgery, 7 with a modified radical mastectomy and 3 with a radical mastectomy, due to gross invasion of the pectoralis major muscle. CONCLUSION: A subareolar palpable breast mass was the most common presenting symptom of the male breast cancer patients. The optimal treatment for male breast cancer patients is a modified radical mastectomy, combined with radiotherapy, chemotherapy, and hormonal therapy, due to the higher hormone receptors positivity.
Breast Neoplasms ; Breast Neoplasms, Male ; Breast* ; Carcinoma, Adenoid Cystic ; Carcinoma, Ductal ; Carcinoma, Intraductal, Noninfiltrating ; Drug Therapy ; Early Diagnosis ; Follow-Up Studies ; Humans ; Lymph Nodes ; Male* ; Mastectomy, Modified Radical ; Mastectomy, Radical ; Mortality ; Neoplasm Metastasis ; Neoplasm Staging ; Radiotherapy ; Retrospective Studies ; Risk Factors

No abstract available.
Anesthesia, Spinal* ; Dilatation, Pathologic* ; Marfan Syndrome*