Amebic liver abscess (ALA) has been diagnosed in travelers to endemic areas or in patients with immunosuppression secondary to human immunodeficiency virus infection since the late 1990s. Further, it is a rare disease in Korea. ALA should be considered in patients present with fever and right upper quadrant pain along with a risk of exposure to amebiasis. We report an 82-year-old man with symptoms of fever, gross hematuria and severe renal impairment as having amebic liver abscess complicated with the obstruction of the inferior vena cava. Amebic liver abscess was successfully treated with antibiotics alone. Also, hematuria disappeared and renal dysfunction improved after treatment.
Aged, 80 and over ; Amebiasis ; Anti-Bacterial Agents ; Fever ; Hematuria ; HIV ; Humans ; Immunosuppression ; Korea ; Liver Abscess, Amebic* ; Rare Diseases ; Renal Insufficiency ; Vena Cava, Inferior*

BACKGROUND: Due to the irreversible nature of chronic obstructive pulmonary disease (COPD), the treatment aim in patients with COPD is not to cure but to reduce the symptoms, increase lung function, and improve the quality of life. It has been suggested that depression is a common emotional disturbance in patients with COPD who are faced with a major physical impairment and embarrassing symptoms. This study evaluated the prevalence and risk factors of depression in patients with chronic obstructive pulmonary disease. METHODS: A total of 59 patients with a registered diagnosis of chronic obstructive pulmonary disease were selected. Depression was assessed using the Centers for Epidemiologic Studies Depression (CES-D) scale. The quality of life was assessed using the Korean version of the St. George's Respiratory Questionnaire. RESULTS: The prevalence of depression was 17.0%. In the correlation model, the interaction of the FEV1% over predicted value and SGRQ score(symptom, activity, impact, overall score) was statistically significant. The interaction of the FEV1% over predicted value and depression scale(CES-D) was also statistically significant. There was a positive correlation between the SGRQ scores(symptom, activity, impact, overall score) and the depression scale. CONCLUSION: The prevalence of depression in patients with chronic obstructive pulmonary disease is relatively high. The pulmonary function and the living standards were found to be significant risk factors for depression.
Affective Symptoms ; Depression ; Epidemiologic Studies ; Humans ; Lung ; Prevalence ; Pulmonary Disease, Chronic Obstructive ; Quality of Life ; Surveys and Questionnaires ; Risk Factors ; Socioeconomic Factors

PURPOSE: We wanted to evaluate the risk factors for developing lymphedema following axillary lymph node dissection in breast cancer patients. METHODS: Ninety-six patients who underwent axillary dissection for breast cancer were followed-up for up to 1 year. Lymphedema was assessed using a serial circumferential measurement method. More than a 2 cm difference in circumference was considered as clinically significant lymphedema. The effects of age, the body mass index (BMI), the cancer stage, chemotherapy, radiotherapy, the location of cancer and creating a latissimus dorsi (LD) flap on the development of lymphedema were analyzed. RESULTS: The incidence of lymphedema was increased with the advancing cancer stage. Radiotherapy was found to increase the incidence of lymphedema. Patients who had received an LD flap showed a lower incidence of lymphedema. CONCLUSION: These results could be useful as a clinical guideline for creating a management plan for postoperative lymphedema. Because there are some differences in the results between all the relevant reports, including ours, further research is needed in the form of a large, multi-center, long-term study.
Body Mass Index ; Breast Neoplasms* ; Breast* ; Drug Therapy ; Humans ; Incidence ; Lymph Node Excision ; Lymphedema* ; Radiotherapy ; Risk Factors* ; Superficial Back Muscles

The bicoronal incision, popularized by Tessier, provides wide access to the orbits, nose, and zygomas as well as the cranium. But blood loss is unavoidable. We attempt to reduce the blood loss and the transfusion with tumescent technique. Athors had performed 17 cases of bicoronal incision between June, 2002 and march, 2003. 8 cases of them underwent the procedure with tumescent solution(Group A). 9 cases was done by usual manner(Group B). We analyzed 23 cases undergiong bicoronal incision for the blood loss and the transfusion amount. Intraoperative blood loss, postoperative transfusion was reduced at Group A. And the dissecting was easy. We think that tumescent technique contributes to reduce the bleeding, additionally reduce the postoperative transfusion.
Hemorrhage ; Nose ; Orbit ; Postoperative Hemorrhage ; Skull ; Zygoma

Orbital mass is about 17% of orbital disease and only 7-8% of mass is lymphoma. Lymphoma involved extraocular muscles are unusual. Lymphoma occurred in lateral rectus muscle, rarely. The authors experienced a case of malignant lymphoma occurred in the lateral rectus muscle in 17-year-old male. His main symptom was exopthalmos and diplopia. The patient was treated with excision via bicoronal approach and radiation. We report the unusual case of malignant lymphoma occurred in lateral rectus muscle.
Adolescent ; Diplopia ; Humans ; Lymphoma* ; Male ; Muscles ; Orbit ; Orbital Diseases

There have been various methods of reduction mandibular angleplasty. 21-year old woman with prominent mandibular angle and body was done curved angle ostectomy with tangential ostectomy. In operation, we had used bone wax for controlling of bone bleeding. After 1 year, the patient revisited to our clinic because she had a mass with tenderness on Lt. mandibular angle area. The mass had been gradually increasing in severity after reduction mandibular angleplasty. Computed tomography of the patient showed inflammatory lesion in Lt. mandibular angle area with focal cortical bony destruction and adjacent soft tissue thickening. After surgical removal of mass, clinical pathology revealed that the mass was chronic inflammatory fibrosis around foreign body(bone wax). The postoperative course was uneventful, the patient was satisfied for her shape. If possible we must avoid using a bone wax in reduction mandibular angleplasty, because bone wax can induce inflammatory reaction and fibrosis.
Female ; Fibrosis ; Hemorrhage ; Humans ; Pathology, Clinical ; Young Adult

The zygomatic bone is a major portion of the midfacial skeleton, forms the malar eminence and the four adjacent bony articulation, when the zygomatic bone was fractured, the patient was suffered from not only esthetic facial contour problem but also functional disturbance such as eyeball movement and masticatory action. This retrospective study comprised 269 patients who had 280 zygoma fractures by various accidents and treated in Pusan Paik hopital between October 1994 and October 1999. The medical records of these 269 patients with zygoma fracture were reviewed and analysed. The studied items are the time of the accidents, the age and sex distribution, the causes of the injuries, anatomical types of the fractures, associated maxillofacial and non- maxillofacial trauma, the treatment methods and fixation materials and the days of hospitalization and complications. The results were obtained. The most patients with zygomatic bone fracture were injured between 22:00 and 04:00. The incidence of zygomatic bone fracture was shown to be decreased annually. The monthly incidence was the highest in January, May and October. The highest incidence in age distribution was the second and third decade(45%) and male to female ratio was 4.7:1. And the most common cause of the zygomatic bone fracture was motor vehicle accident(51%) followed by fall down, assault, industrial accident and sports accident. The most common anatomical site of the zygomatic bone fracutre was group III type fracture(33%) by Knight and North Classification. Associated maxillofacial bone fracture was mainly maxilla, followed by nasal bone, mandible, and frontal bone. The most prevalent time interval between onset and surgical intervention was within the 10 days and the prevalent interval time between the surgical intervention and discharge was within the 14 days. Postoperative compliction was malocclusion(2 cases).
Accidents, Occupational ; Age Distribution ; Busan ; Classification ; Female ; Fractures, Bone ; Frontal Bone ; Hospitalization ; Humans ; Incidence ; Male ; Mandible ; Maxilla ; Medical Records ; Motor Vehicles ; Nasal Bone ; Retrospective Studies ; Sex Distribution ; Skeleton ; Sports ; Zygoma*

In general, Oriental people have thicker facial skin with more subcutaneous adipose tissues than Caucacian people. These differences result in characteristic Oriental aging face combined with squared facial contours. Conventional face lift essentially consists of facial wrinklinges and reducing flaccidity of facial skin but squared facial contouring is not considered. Flat and squared face can be improved by reduction malarplasty and mandibular angleplasty, thoses are the common facial bone contouring surgeries performed in the Orient. If patients, who have aging face, also have flat and squared face, it is necessary to be performed face lift and facial bone contouring surgery simultaneously. We have experienced 18 cases of patients with aging face and squared face who were operated face lifting procedures combined with maloplasty or angleplasty(from Apr.1997 to Mar. 2001). And We have satisfactory results on most patients(16 cases of patients were satisfied with results).
Aging ; Facial Bones ; Humans ; Rejuvenation* ; Rhytidoplasty ; Skin

In case of soft-tissue defects with bone and tendon exposure on foot, ankle and lower leg, it is often impossible to achieve wound closure by a simple skin graft. The sural artery flap is a fasciocutaneous flap supplied by the sural artery that accompanies the sural nerve and connects with a septocutaneous perforator of the peroneal artery via a suprafascial network of vessels. For the coverage of the defects, we operated 30 cases using modified superficial sural fasciocutaneous island flap based on the proximal or distal. and we covered convoluted wound site with this flap with plicated fascia. We reconstruct complicated skin defects on the foot region(13) and the distal portion of the leg(17). The size of flap varied from 3 x 4 cm2 to 10 x 9 cm2. All 30 flaps survived completely, but minor complications, such as venous congestion, hematoma disappeared after a few days. The main advantage of this flap is a constant and reliable blood supply without sacrifice of a major artery. but disadvantage of this flap is hypoesthesia at the lateral part of the foot. In conclusion, dissection of the superficial sural fasciocutaneous island flap is quite easy and requires less time, and involves less risk to the patient. The nonbulky fasciocutaneous island flap appearance particularly indicated small to medium sized defects with or without convoluted wound surface. The contours of the recipient and donor sites are acceptable aesthetically.
Ankle ; Arteries ; Fascia ; Foot ; Hematoma ; Humans ; Hyperemia ; Hypesthesia ; Leg ; Skin ; Sural Nerve ; Tendons ; Tissue Donors ; Transplants ; Wounds and Injuries

No abstract available.
Administration, Intravesical* ; Photochemotherapy* ; Urinary Bladder Neoplasms* ; Urinary Bladder*