• Parasites, Hosts and Diseases
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• 제44권2호
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• pp.139-143
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• 2006

Peripheral gangrene, characterized by distal ischemia of the extremities, is a rare complication in patients with falciparum malaria. Patients with this complication have generally undergone early amputation of the affected areas. In this report, we describe 3 adult Thai patients presented at the Hospital for Tropical Diseases, Bangkok, with high grade of fever ranged 6-9 days, jaundice, acute renal failure, respiratory failure, alteration of consciousness and shock. Two patients had gangrene developed at the lower extremities on day 1 of hospitalization and 1 patient had gangrene developed on day 3. Blood smears revealed hyperparasitemia with Plasmodium falciparum. These patients were diagnosed as having severe malaria with peripheral gangrene. The resolution of gangrene was successfully achieved by treatment with artesunate and conservative treatment in 2 of 3 cases.

• 대한간호
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• 제6권3호통권29호
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• pp.37-41
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• 1967

• Tuberculosis and Respiratory Diseases
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• 제57권4호
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• pp.381-385
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• 2004

저자들은 클렙시엘라균종에 의한 폐렴에 동반된 폐 괴저를 수술적 치료없이 약물로만 호전시킨 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• 대한족부족관절학회지
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• 제22권1호
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• pp.32-37
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• 2018

Purpose: Diabetic foot gangrene has a high morbidity rate and a great influence on the quality of life. Amputation is an appropriate treatment if conservative treatment is impossible according to the severity of gangrene and infection. The purpose of this study was to evaluate the usefulness of preoperative percutaneous transluminal angioplasty for the postoperative outcome. Materials and Methods: From February 2013 to April 2016, among 55 patients with diabetic foot gangrene, who require surgical treatment, percutaneous transluminal angioplasty was performed on patients with an ankle brachial index (0.9 and stenosis) 50% on angiographic computed tomography. The study subjects were 49 patients, comprised of 37 males (75.5%) and 12 females (24.5%). The mean age of the patients was $70.0{\pm}9.6years$. The treatment results were followed up according to the position and length of the lesion and the changes during the follow-up period. Results: As a result of angiography, there were 13 cases of atherosclerotic lesions in the proximal part, 11 cases in the distal part and 25 cases in both the proximal and distal parts. As a result of the follow-up after angiography, in 13 patients, the operation was not performed and only follow-up and dressing were performed around the wound. Sixteen patients underwent debridement for severe gangrene lesions and 20 patients, in whom the gangrene could not be treated, underwent amputation (ray amputation or metatarsal amputation, below knee amputation). Conclusion: Preoperative percutaneous angioplasty in diabetic foot gangrene patients with peripheral vascular occlusive disease is simple, and 59.2% of the patients with diabetic foot gangrene could be treated by conservative treatment or debridement.

• Archives of Reconstructive Microsurgery
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• 제12권1호
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• pp.13-18
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• 2003

Fournier's gangrene is a synergistic necrotizing fasciitis of the perineal, perirectal and urogenital area and can be fatal unless treated in early stage. Perianal and urogenital infections are common causes of the disease but it can occur after artificial procedure on perineal area using by surgical instruments. It is mixed aerobic and anaerobic infection and E. coli is the most common causative bacteria. Untill now many investigators have focused on early diagnosis, preserving hemodynamic stability, broad-spectrum systemic antibiotics and treatment of underlying disease in management of Fournier's gangrene. The authors have experienced five patients of chronic liver disease whose necrotizing perineal infections developed spontaneously and treated them aggressively as described above and reconstructed perineal soft tissue defects using by various surgical methods, then we got good results both functionary and cosmetically. From now on, we would better reconstruct soft tissue defect of perineum with skin graft or pedicled flap in early stage when treat Fournier's gangrene, thereafter we can get an ultimate increase in patient's life quality.

• 대한족부족관절학회지
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• 제23권4호
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• pp.196-200
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• 2019

Symmetrical Digital Gangrene (SDG) is characterized by the sudden onset of peripheral, symmetrical gangrene in the absence of any major vascular occlusive disease. Catecholamine inotropes are frequently used for the treatment of septic shock combined with an unstable hemodynamic state, and their usage can rarely induce SDG. There is no standard treatment for the SDG. Early recognition and prompt management of sepsis and expeditious process of weaning off of the inotropes are necessary to prevent progression of SDG. To the best of our knowledge, this is the first report in Korea regarding the treatment of SDG induced by catecholamine inotropes.

• 사상체질의학회지
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• 제16권3호
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• pp.129-132
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• 2004

1. Objectives Besides Diabetes Mellitus, its complications are matter of concerns as well. Its following complications are cardiovascular disease, glomerulopathy, retinopathy, neuropathy and diabetic gangrene. These complications can cause overall damage in major organs. In traditional oriental medicine it has been perceived that gangrene is mainly caused by "hwa(火)" but under sasang constitutional medicine its has been diagnosed as Taeumin superficial-disease(太陰人 表病) and Taeumin Jowiseungchung-tang(調胃升淸湯) was prescribed. As a result, significal improvments was noted and thefore we report the outcome. 2. Methods We have given Taeumin Jowiseungchung-tang(太陰人 調胃升淸湯) to a patient for treating diabetes complications. 3. Results This patient was treated with Sasang Constitional Medicine and acupuncture for about three weeks. After treatment, ulcer and whole body edema were improved considerbly. 4. Conclusions We have dianosed the patient as Taeumin superficial-disease(太陰人 表病) by undergoing several diagnostic method used in sasang constutional medicine. Therefore we have given Taeumin Jowiseungchung-tang(太陰人 調胃升淸湯) to the patient and has obtained satisfactory results in curing several diabetic complications especially ulcer due to diabetes.

• Archives of Plastic Surgery
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• 제49권3호
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• pp.453-456
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• 2022

When the scrotal sac is entirely debrided following a Fournier gangrene, testes exposure poses unique challenges for the reconstructive surgeon. Despite the anterolateral thigh (ALT) flap is considered a workhorse in such context, aesthetic results are often suboptimal because of the lack of natural ptosis and patchwork appearance. We describe the use of a super-thin pedicled ALT flap for total scrotal reconstruction, modified according to a peculiar flap design and inset technique. A 42-year-old man was referred to our department for delayed total scrotal reconstruction 8 months after a Fournier gangrene extensive debridement. A super-thin pedicled ALT flap from the right thigh was designed: in the central portion of the ALT, a lateral skin paddle extension was marked to guarantee adequate posterior anchorage during insetting and ptosis of the scrotal sac. This particular flap arrangement has inspired the name "sombrero" as the shape is akin to the famous hat. No secondary refinements were needed, and the patient showed satisfying aesthetic and functional results at 12 months' follow-up. The ALT flap design "sombrero" modification proposed in this article can improve scrotum cosmesis and patient satisfaction in a single-stage single-flap procedure.

• 대한족부족관절학회지
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• 제11권2호
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• pp.216-220
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• 2007

Purpose: To evaluate the effectiveness of percutaneous transluminal angioplasty (PTA) below the knee as a treatment in diabetic foot gangrene. Materials and Methods: Between May 2003 and May 2006, angiography was performed in 35 diabetic foot gangrene classified as either Wagner grade IV or V. Infrapopliteal PTA was performed in 10 patients among them. Clinical success was defined as prevention of major amputation. Results: Among 25 patients who did not receive infrapopliteal PTA, the major amputation rate is 22% (in one arterial occlusion cases), 50% (in two arterial occlusion cases), 63% (in three arterial occlusion cases), respectively. Infrapopliteal PTA was successfully performed in 8 among 10 patients. Two patients were failed and undergone below-knee amputation. Toe amputation were performed in 2 patients with one arterial occlusion. Out of 6 patients with three arterial occlusions, toe amputations were performed in 4 patients and the other 2 patients were healed through debridement. Conclusion: As a first choice revascularization procedure for limb salvage in diabetic foot gangrene, infrapopliteal PTA can be one of treatment options.

• Clinical and Experimental Pediatrics
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• 제45권5호
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• pp.664-668
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• 2002

저자들은 이에 가와사끼병 및 말단 조직괴저가 동반된 혈구 탐식증 1례를 보고하는 바이며, 가와사끼병 환자가 간비종대, 혈소판 감소를 보이는 경우에는 드물지만 혈구 탐식증의 가능성을 배제할 수 없으므로 확진을 위하여 혈청 중성지방의 측정과 골수 생검을 시행하여야 할 것으로 사료하는 바이다.