PURPOSE: The purpose of this study was to evaluate the clinical results of early functional treatment after surgical repair of acute Achilles tendon rupture and to evaluate the isokinetic and isometric concentric plantar flexion peak torque and muscle endurance. We wanted to provide objective results of the functional improvement and the effect of early rehabilitation. MATERIALS AND METHODS: On a retrospective basis, we studied 52 cases of acute Achilles tendon rupture who visited our clinic between March 2007 and August 2009. Eleven patients (9 male, 2 female) were available for the follow-up more than 12 months and their mean final follow-up duration was 18.2 (12 to 39) months. We performed early weight-bearing and ankle exercise after surgical repair of acute Achilles tendon rupture. At final follow-up, patients were evaluated with clinical and functional examination using Arner-Lindholm scale and American Foot and Ankle Society (AOFAS) Ankle-Hindfoot scale and patients' subjective satisfaction. In addition, the isokinetic and isometric concentric plantar flexion peak torque and muscle endurance were evaluated. RESULTS: Evaluating the clinical results using the Arner-Lindholm scale, we had 4 excellent cases and 7 good cases. The average AOFAS score was 88.9 (68 to 100) points at final follow-up. The patients' subjective satisfaction was excellent in 5 cases and good in 6 cases. The isokinetic concentric plantar flexion peak torque was restored to 92.2% (30degrees/sec) and 97.0% (120degrees/sec) in relation to the intact side at final follow-up. The isometric concentric plantar flexion peak torque was restored to 89.4% at 10o dorsiflexion, 84.4% at neutral, and 84.0% at 20degrees plantar flexion of the ankle position in relation to the intact side. The muscle endurance of ankle plantar flexor was 62.37% for the intact side and 59.16% for the injured side that there was no difference between the intact and injured side (p=0.79). CONCLUSION: The clinical results and the satisfactory restoration of muscle power and endurance support early full weight bearing and exercise as an acceptable form of rehabilitation.
Achilles Tendon ; Animals ; Ankle ; Follow-Up Studies ; Foot ; Humans ; Male ; Muscle Strength ; Muscles ; Retrospective Studies ; Rupture ; Torque ; Weight-Bearing

PURPOSE: To investigate the care patterns for radiation therapy and to determine inter-hospital differences for patients with laryngeal carcinoma in Korea. MATERIALS AND METHODS: A total of 237 cases of laryngeal carcinoma (glottis, 144; supraglottis, 93) assembled from 23 hospitals, who underwent irradiation in the year of 1998 and 1999, were retrospectively analyzed to investigate inter-hospital differences with respect to radiotherapy treatment. We grouped the 23 hospitals based on the number of new patients annually irradiated in 1998; and designated them as group A (> or =900 patients), group B (> or =400 patients and <900 patients), and group C (<400 patients). RESULTS: The median age of the 237 patients was 62 years (range, 25 to 88 years), of which 216 were male and 21 were female. The clinical stages were distributed as follows: for glottis cancer, I; 61.8%, II; 21.5%, III; 4.2%, IVa; 11.1%, IVb; 1.4%, and in supraglottic cancer, I; 4.3%, II; 19.4%, III; 28.0%, IVa; 43.0%, IVb; 5.4%, respectively. Some differences were observed among the 3 groups with respect to the dose calculation method, radiation energy, field arrangement, and use of an immobilization device. No significant difference among 3 hospital groups was observed with respect to treatment modality, irradiation volume, and median total dose delivered to the primary site. CONCLUSION: This study revealed that radiotherapy process and patterns of care are relatively uniform in laryngeal cancer patients in Korean hospitals, and we hope this nationwide data can be used as a basis for the standardization of radiotherapy for the treatment of laryngeal cancer.
Female ; Glottis ; Humans ; Immobilization ; Korea ; Laryngeal Neoplasms ; Male ; Retrospective Studies

As the radiotherapy technique development, the needs for using of medical electronic chart in the department of radiation oncology is growing. However, the complexity of affairs of radiation oncology make it difficult to develop a electronic medical chart. In this study, we introduce the electronic medical chart developed by domestic hospital. The function and example of electronic medical chart designed as radiation treatment progress was showed and the future study was presented.
Electronics ; Electrons ; Radiation Oncology

As the radiotherapy technique development, the needs for using of medical electronic chart in the department of radiation oncology is growing. However, the complexity of affairs of radiation oncology make it difficult to develop a electronic medical chart. In this study, we introduce the electronic medical chart developed by domestic hospital. The function and example of electronic medical chart designed as radiation treatment progress was showed and the future study was presented.
Electronics ; Electrons ; Radiation Oncology

BACKGROUND: Necrotizing fasciitis is a life threatening severe soft tissue infection primarily involving the fascia and the subcutaneous tissue with thrombosis of the cutaneous microcirculation. The purpose of the study was to analyze the microbiological and clinical characteristics of necrotizing fasciitis in Korea and to suggest adequate antibiotic therapy. METHODS: We retrospectively reviewed medical records of three Soonchunhyang University Hospitals in Seoul, Bucheon and Cheonan. Patients admitted for skin graft or secondary treatment were excluded. Blood cultures were obtained at the time of admission and pus cultures were obtained at the time of first operative debridement. RESULTS: Twenty two patients (16 males, 6 females, 16~82 years old, median age: 59 years old) were enrolled for this study. Fourteen pateints underwent surgical treatment and 2 of them died of necrotizing fasciitis. Gram positive organisms were isolated in 13 cases and gram negative organisms were isolated in 11 cases. Third generation cephalosporin resistant gram negative organisms were isolated in 3 cases. CONCLUSIONS: This study suggest that characteristics of necrotizing fascitis in Korea were; high proportion of aged person, predominance of type 2 necrotizing fascitis and increasing tendency of third generation cephalosporin resistant gram negative bacterial infections. Consequently, initial choice of empirical antibiotics for necrotizing fasciitis should consider 3rd generation cephalosporin resistant gram negative organisms. Prompt surgical debridement and adequate antimicrobial therapy are mandatory for improved survival.
Anti-Bacterial Agents ; Cephalosporin Resistance ; Chungcheongnam-do ; Debridement ; Fascia ; Fasciitis, Necrotizing* ; Female ; Gram-Negative Bacterial Infections ; Gyeonggi-do ; Hospitals, University* ; Humans ; Korea* ; Male ; Medical Records ; Microcirculation ; Retrospective Studies ; Seoul ; Skin ; Soft Tissue Infections ; Subcutaneous Tissue ; Suppuration ; Thrombosis ; Transplants

KearnsSayre syndrome (KSS) is a mitochondrial DNA disorder characterized by the onset before age 20 years, progressive external opthalomoplegia, atypical retinal pigmentation and cardiac conduction disturbance. This report describes a 24-year-old woman who experienced syncope due to complete atrioventricular block complicated by KSS. At 12 years old, she was diagnosed KSS. The consecutive change of EKG shows typical progression of cardiac conduction disturbance of KSS. She was successfully treated with implantation of a pacemaker.
Atrioventricular Block* ; Child ; DNA, Mitochondrial ; Electrocardiography ; Female ; Humans ; Kearns-Sayre Syndrome ; Pigmentation ; Retinaldehyde ; Syncope ; Young Adult

Sarcomatoid carcinoma of the common bile duct (CBD) is an extremely rare malignant neoplasm, which is characterized by the presence of carcinomatous and sarcomatous components. We report a case of sarcomatoid carcinoma arising in the distal CBD. The patient was a 68- year-old woman who presented with abdominal pain. The computed tomography and endoscopic ultrasonography revealed a polypoid mass in the distal CBD. The resected specimen showed a polypoid mass with a narrow stalk in the distal CBD which was confined to the mucosa. The cut surface revealed a gray-whitish solid mass with focal hemorrhage and necrosis. Microscopically, the tumor was composed of carcinomatous and sarcomatous components without any heterologous elements. The sarcomatous area predominently consisted of pleomorphic spindle cells. The carcinomatous component was an adenocarcinoma. On immunohistochemistry, cytokeratin was coexpressed in the carcinomatous and sarcomatous components but vimentin was expressed exclusively in the sarcomatous component. The patient has been doing well for one year postoperatively.
Abdominal Pain ; Adenocarcinoma ; Common Bile Duct* ; Endosonography ; Female ; Hemorrhage ; Humans ; Immunohistochemistry ; Keratins ; Mucous Membrane ; Necrosis ; Vimentin

Malakoplakia is a rare chronic inflammatory process, most commonly affecting the urinary tract. This entity was first described by Michaelis and Gutman in 1902. As of 1995, only 85 cases of malakoplakia of the gastrointestinal tract has been reported. The common sites of colonic involvement are the rectum, sigmoid, and right colon, in descending order of frequency. The most common disease associated with malakoplakia is colorectal carcinoma. Surgical resection is the treatement of choice for cases associated with carcinoma or complications. But in other cases, medical treatment could be attempted. Antimicrobial drugs, such as trimethoprime-sufamethoxazole, rifampin, or as recently suggested, ciprofloxacin can be used. We report a case of rectal malakoplakia treated by ciprofloxacin with a review of literatures.
Anti-Bacterial Agents* ; Ciprofloxacin ; Colon ; Colon, Sigmoid ; Colorectal Neoplasms ; Gastrointestinal Tract ; Malacoplakia* ; Rectum* ; Rifampin ; Urinary Tract

Lymphoepithelioma-like carcinoma (LELC) occurs in esophagus, stomach, bile duct, salivary gland, lung, uterus, skin, and so on. The incidence of gastric LELC is 1~4 percents of all stomach cancers. Gastric LELC has a lymphoid stroma and shows a good prognosis and high association with Epstein-Barr virus. We experienced a case of patient with gastric LELC. The patient was 49-year-old woman. and the endoscopic finding showed a submucosal tumor with central erosion. The histologic findings of endoscopic biopsies were suggestive of low grade MALT lymphoma. but the histologic findings of the surgical specimen were consistent with gastric LELC. We report a case of gastric LELC presenting as a submucosal tumor, with a brief review of the literature.
Bile Ducts ; Biopsy ; Esophagus ; Female ; Herpesvirus 4, Human ; Humans ; Incidence ; Lung ; Lymphoma, B-Cell, Marginal Zone ; Middle Aged ; Prognosis ; Salivary Glands ; Skin ; Stomach ; Stomach Neoplasms ; Uterus

Gastric wall abscess is a form of phlegmonous gastritis and has been very rarely reported. The pathogenesis of gastric wall abscess is thought to involve a focal injury to the gastric mucosa such as a penetrating trauma from an ingested foreign body or an endoscopic biopsy, where by bacterial infection occurs. Gastritis cystica profunda is a rare disease in which hyperplasia of mature glandular epithelium extends into the tissues beneath the submucosa. It shows multiple small cysts in the mucosa and submucosa of the stomach. To our knowledge, the association of gastric wall abscess with gastritis cystica profunda has never been reported yet. We, recently, experienced a case of gastric wall abcess associated with gastritis cystica profunda. Herein, we report it with a brief review with literatures.
Abscess* ; Bacterial Infections ; Biopsy ; Cellulitis ; Epithelium ; Foreign Bodies ; Gastric Mucosa ; Gastritis* ; Hyperplasia ; Mucous Membrane ; Rare Diseases ; Stomach