49 strains of Pseudomonas aeruginosa were isolated from chronic wounds associated with orthopedic surgical field at Taegu armed forces general hospital. In the present report, authors have studied the Pyocin type of isolated strains by Gillies and Govans method. Also observed various interrelationship in associaton with Pyocin type, Pyocyanine formation, Oxidase reaction and antibiotic sensitivity. The results were obtained as follows; 1) Among the 49 strains tested in term of pyocin type, 41 strains(81.6%) were found to be typable and 8 strains (16.4%) to be untypable. Among the pyocin type of 41 typables, unclassified type was the most prominent type 17 strains (41.5%) and followed by type I(11 strains), 10 (3 strains), 5 (2 strains) and other type. 2) In the relationship among pyocyanine formation, oxidase reaction and pyocin type, no definite conclusion can be reached due to the paucity of tested strains except that more strains belong to the pyocin type I of the Pyocyanine negative strains. 3) In antibiotic sensitivity of isolated strains tested by plate dilution method, most of all strains were resistant to Kanamycin and Neomycin but few strains were moderate sensitive to Colistin, Polymyxin B, and Terramycin. 4) The Pyocin type of isolated strains were not related with antibiotic sensitivity to Colistin, Polymyxin B and Terramycin substantially.
Arm ; Colistin ; Daegu ; Hospitals, General ; Kanamycin ; Methods ; Neomycin ; Orthopedics ; Oxidoreductases ; Oxytetracycline ; Polymyxin B ; Pseudomonas aeruginosa ; Pseudomonas ; Pyocins ; Pyocyanine ; Wounds and Injuries

Three cases of spondyIolysis were experienced and treated by anterior interbody fusion of the involved spines at the department of orthopaedic surgery in the Taegu Hospital One case was accompanied with severe lumbago with radiating pain and other two cases with lumbago significantly. Review of literature was done with report of three cases of spondylolysis.
Daegu ; Low Back Pain ; Spinal Fusion ; Spine ; Spondylolysis

BACKGROUND AND OBJECTIVES: Little information about the surgical anatomy and technique for retropharyngeal node dissection has been published. The purpose of this study was to review our surgical technique and results of retropharyngeal lymph node dissection. MATERIALS AND METHODS: Eleven advanced oropharyngeal and hypopharyngeal squamous cell carcinoma patients who had been treated with resection of primary tumor and standard neck dissection including retropharyngeal lymph node dissection from 1994 to 1999 were evaluated retrospectively. RESULTS: One of 11 patients had positive retropharyngeal lymph node. The surgical technique used for retropharyngeal lymph node dissection were total laryngopharyngectomy, mandibular splitting or mandibulectomy approach. There was no specific complication of retropharyngeal lymph node dissection except one case of Horner's syndrome. CONCLUSION: Retropharyngeal lymph node dissection was a safe procedure, bet it required total laryngopharyngectomy, madibular splitting or mandibulectomy approach. It was possible to remove retropharyngeal lymph made en-bloc with primary tumor in most cases.
Carcinoma, Squamous Cell ; Horner Syndrome ; Humans ; Hypopharyngeal Neoplasms ; Lymph Node Excision* ; Lymph Nodes* ; Neck Dissection ; Oropharyngeal Neoplasms ; Retrospective Studies

Displaced fracture of the ankle are probably the most common skeletal injury managed today by open reduction and internal fixation. But, it is recommended that metallic implant might be removed to restore normal biomechanical forces on hone and to reduce discomfort directly under the skin. in order to reduce the resources needed for the removal of metallic fixation devices, absorbable impiants of biodegradable synthetic polymers were deveioped. However reports of clinical application of such implants have so far been very few. This prospective study represents the good resuits in 15 displaced non-comminuted closed malleolar fractures of the ankle treated using hiodegradahle internal fixation in department of orthopedic surgery of Kwang Myung Sung Ae general hospitai from June I 995 to December 1996. The results were as follows 1. All cases were united and the average time for union was 7.6 weeks. 2. As a results of comparison with normal side, a restriction of 10 degrees or more of dorsiflexion of the ankle joint was present in 4 cases, a restriction of 20 degrees or more of plantar tlexion was present in 2 cases, a restriction of supination was present in 3 cases and a restriction of plantar flexion was present in 4 cases. 3. According to Phillips functional scoring scale, 4 cases were excellent, 7 cases good, 4 cases fair and no cases were poor. 4. There were no complications in all cases.
Ankle ; Ankle Joint ; Orthopedics ; Polymers ; Prospective Studies ; Skin ; Supination

BACKGROUND AND OBJECTIVES: Stomal recurrence is defined as a diffuse infiltration of neoplastic tissue at the junction of amputated trachea and skin. The incidence of stomal recurrence has been reported to be 5-15% and it is regarded to be related with several risk factors such as subglottic extension of tumor, advanced T stage, paratracheal lymph node metastasis, previous tracheotomy or the invasion of thyroid gland. The principal treatment is an extensive surgery, however, the prognosis is often extremely poor. Therefore, prevention is regarded to be much more important. The purpose of this study was to evaluate the clinical characteristics of stomal recurrence and to clarify the associated risk factors, methods of prevention and proper management. MATERIALS AND METHODS: We reviewed the data of 178 followed-up patients who underwent total laryngectomy for laryngeal or hypopharyngeal cancers from 1987 to 1996. Among them, 10 cases of stomal recurrence were studied. RESULTS: The overall incidence of stomal recurrence was 5.6% and there was no significant difference according to primary site, T stage and N stage. Subglottic involvement of tumor and previous tracheotomy were positively correlated with the increased incidence of stomal recurrence. CONCLUSION: For cases with such risk factors as considered here, more extensive and meticulous surgery is required. Considering the high rate of mortality, the effort for prevention of stomal recurrence is much more important.
Humans ; Hypopharyngeal Neoplasms ; Incidence ; Laryngectomy ; Lymph Nodes ; Mortality ; Neoplasm Metastasis ; Prognosis ; Recurrence* ; Risk Factors ; Skin ; Thyroid Gland ; Trachea ; Tracheotomy

BACKGROUND AND OBJECTIVES: Velopharyngeal insufficiency from wide resection of soft palate and pharyngeal wall cause swallowing and articulation difficulty. Recently, reconstruction options have been significantly expanded and revitalized by the advent of free tissue transfer. The purpose of the present study was to report retrospectively collective articulation function scores and velopharyngeal function in patients who had reconstruction of radial forearm free flaps after primary resection for oropharyngeal cancer. SUBJECTS AND METHOD: Ten patients treated for oropharyngeal cancer by wide excision of primary lesion and reconstruction with radial forearm free flap were included. Assessment of speech intelligibility, diadochokinetic test, articulation discrimination test, nasometer, and velopharyngeal orifice examination with fiberoptic nasopharyngoscope was accomplished. Ten patients were classified into 4 groups according to the extent of surgical defect and portion of resection as follows. Group I: only one side of the lateral pharyngeal wall and palatine tonsil area (n=2), Group II: One side of palatine tonsil and soft palate (n=3), Group III: One side of palatine tonsil, soft palate, and part of the posterior pharyngeal wall (n=2), Group IV: One side of palatine tonsil, soft palate which reached beyond the uvula to opposite side, and part of the posterior pharyngeal wall (n=3). RESULTS: In the speech intelligibility and articulation discrimination test, five cases which belonged to the group I and II were evaluated to show excellent state. Five cases which belonged to group III and IV were judged to show moderate state. These results resulted from hypernasality of patients in group III and IV. In the articulation discrimination test, the results was increasingly affected with hypernasality from group I to group IV. In the nasometer test, patients of group III and IV were judged to show higher nasalance scoress (nasality) than those of group I and II. In the velopharyngeal orifice examination with fiberoptic nasopharyngoscope, near perfect closure or complete closure was achieved in an effort to bring about velopharyngeal closure in group I and II. But a small space was evident in the side reconstructed with a free flap in group III. In group IV, velopharyngeal space was not closed. CONCLUSION: We believe that this study aids in counseling patients and predicting their postoperative status of speech and velopharyngeal function according to the size of primary defect and the design of reconstruction. But, a prospective, randomized study will be needed for better evaluation.
Counseling ; Deglutition ; Discrimination (Psychology) ; Forearm ; Free Tissue Flaps ; Humans ; Oropharyngeal Neoplasms* ; Oropharynx ; Palate, Soft ; Palatine Tonsil ; Retrospective Studies ; Speech Intelligibility ; Uvula ; Velopharyngeal Insufficiency

BACKGROUND: This study aimed to investigate whether stimulated C-peptide is associated with microvascular complications in type 2 diabetes mellitus (DM). METHODS: A cross-sectional study was conducted in 192 type 2 diabetic patients. Plasma basal C-peptide and stimulated C-peptide were measured before and 6 minutes after intravenous injection of 1 mg glucagon. The relationship between C-peptide and microvascular complications was statistically analyzed. RESULTS: In patients with retinopathy, basal C-peptide was 1.9+/-1.2 ng/mL, and stimulated C-peptide was 2.7+/-1.6 ng/mL; values were significantly lower compared with patients without retinopathy (P=0.031 and P=0.002, respectively). In patients with nephropathy, basal C-peptide was 1.6+/-0.9 ng/mL, and stimulated C-peptide was 2.8+/-1.6 ng/mL; values were significantly lower than those recorded in patients without nephropathy (P=0.020 and P=0.026, respectively). Stimulated C-peptide level was associated with increased prevalence of microvascular complications. Age-, DM duration-, and hemoglobin A1c-adjusted odds ratios for retinopathy in stimulated C-peptide value were 4.18 (95% confidence interval [CI], 1.40 to 12.51) and 3.35 (95% CI, 1.09 to 10.25), respectively. The multiple regression analysis between nephropathy and C-peptide showed that stimulated C-peptide was statistically correlated with nephropathy (P=0.03). CONCLUSION: In patients with type 2 diabetes, the glucagon stimulation test was a relatively simple method of short duration for stimulating C-peptide response. Stimulated C-peptide values were associated with microvascular complications to a greater extent than basal C-peptides.
C-Peptide ; Cross-Sectional Studies ; Diabetes Mellitus, Type 2 ; Glucagon ; Hemoglobins ; Humans ; Injections, Intravenous ; Odds Ratio ; Plasma ; Prevalence

No abstract available.
Angioplasty* ; Constriction, Pathologic* ; Echocardiography, Transesophageal* ; Humans

The number of AIDS patients is currently increasing in Korea, and multiple opportunistic infections, which are due to their immunocompromised state, have become a significant clinical problem. These opportunistic diseases may vary according to the severity of immunosuppression, the mode of transmission, the risk factors, the living environment and treatment; rectal syphilis, perianal condyloma lata and amoebic liver abscess are known to rarely develop in AIDS patients. We report here on a case of a homosexual man who simultaneously presented with an amebic liver abscess, esophageal candidiasis, chronic hepatitis B, rectal syphilis, perianal condyloma lata and asymptomatic neurosyphilis. He was treated with highly active antiretroviral therapy (HARRT) and the appropriate antiviral and antibiotic agents.
Antiretroviral Therapy, Highly Active ; Candidiasis ; Hepatitis B, Chronic ; Homosexuality ; Humans ; Immunosuppression ; Korea ; Liver Abscess, Amebic ; Neurosyphilis ; Opportunistic Infections ; Risk Factors ; Syphilis