Angiosarcoma is rare disease not only in Korea but throughout the world; it is all the more so on the skin. We made an observation on a case of angiosarcoma on the scalp of a 57 year-old man. Noteworthy in this case are: (1) the patient was suffered from a head trauma 6 years prior to onset of the disease, (2) the progress of the disease showed an extreme rapidity accompanied by severe headache intolerable by any medication, (3) no effect was resulted from X-ray irradiation, and (4) the patient survived for 7 months with the disease.
Craniocerebral Trauma ; Headache ; Hemangiosarcoma* ; Humans ; Korea ; Middle Aged ; Rare Diseases ; Scalp ; Skin

Polydactyly is one of the most common congenital anomalies of the limb, however its surgical treatment varies from simple excision to reconstruction. The purpose of this study is to present out classification of polydactyly in which the type of surgery was concerned primarily. Two hundred and thirty five digits(134 fingers and 101 toes) in 188 patients were operated from 1980 to 1992. We divided the polydactyly into two types-the simple type, in which the extradigit arises from only one digit, and the complex type in which the extradigit connects more than two adjacent main digits. The simple type was subdivided into joint type(type I), in that the extradigit has its own joint in its origine; epiphyseal type(type II), the extradigit share common epiphysis with main digit; and hypoplastic type(type III), the extradigit is connected only by soft tissue to the main digit. The epiphyseal type(type II) was further divided into subtype A(type IIA), in that the origin seems to be directly derived from the epiphysis; and subtype B(type IIB), which resemble an osteochondroma. Type III and type IIB can be treated by simple excision, however the type I and type IIB can be treated by arthroplasty with or without osteotomy as well as excision of extradigit. Result of surgical treatment in 1 digit of the simple form, which siginifies the extradigit arising from only one digit, are good in 193 digits(91%), fair 14(6.6%), and poor 5(2.4%) after an average follow-up period of 20 months. Our principles in the surgical treatment of polydactyly was treatment according to the type, and early treatment.
Arthroplasty ; Classification ; Epiphyses ; Extremities ; Fingers ; Follow-Up Studies ; Humans ; Joints ; Osteochondroma ; Osteotomy ; Polydactyly

The femur is the largest long bone in the body which is related to weight bearing. As a result of rapid increase in traffic accidents and industrial injuries, the incidence of femoral shaft fractures has risen also. The methods of treatment in children and adults are different, therefore inadequate treatment can cause permanent disability. The authors have reviewed 211 cases of femoral shaft fractures in 204 persons (children and adults) from September 1967 to September 1976 whe were admitted and treated in Orthopedic Department, Severance Hospital. The results were as follows: 1. The fractures occured commonly in the 6–10 yr. age group (41.2%) in children and in the 21–40 yr. group (54.2%) in adults. Males comprised 138 cases (67.6%). 2. Closed fractures were 185 cases (87.7%) and comminuted fractures were the most common type, 94 cases (44.5%) in all. The fracture site was middle third in 116 cases (55%). 3. Causes were mainly car accidents, 146 cases (71.5%) and industrial injuries. Pedestrian injuries are particularly common in Korea. Many industrial accidents occur due to inadequate working facilities in factories. 4. Associated injuries were common in young adults and in order of frequency these were fractures of the tibia and fibula; skulls; pubic bone. 5. In the early and delayed operation groups, primary bony union rate was better (92%) in the early than the late operation group (78.3%). 6 The period of bony union was 13 weeks with compression plate and screw fixation: 16 weeks with Kuntscher nailing; 17. 5 weeks with plate and screw fixation; and 20 weeks with skeletal traction in adults. 7. Knee joint motion was most limited with skeletal traction (33.5%), less with plate and screw fixation (14.7%) and Kuntscher nailing (1.7%), but none with compression plate and screw fixation. 8. Good results were obtained with conservative treatment in children and operative treatment in adults. 9. Complications were much less frequent in children than in adults and were treated well. 10. Post-operative infection rate was 4.4% and infection was treated well with conservative measures. 11. The 90° – 90° skeletal traction in children and compression plate and screw fixation along with cast brace in adults were recommended.
Accidents, Occupational ; Accidents, Traffic ; Adult ; Braces ; Child ; Clinical Study ; Femur ; Fibula ; Fractures, Closed ; Fractures, Comminuted ; Humans ; Incidence ; Knee Joint ; Korea ; Male ; Orthopedics ; Pubic Bone ; Skull ; Tibia ; Traction ; Weight-Bearing ; Young Adult

No abstract available.

Disseminated intravascular coagulation (DIC) is a pathological syndrome in which activation of coagulation cascade leads to fibrin clot formation, consumption of platelets and coagulation factors, and secondary fibrinolysis. We report a case of severe postoperative hemorrhagic diathesis due to DIC. A 59-year-old man was scheduled for reduction of tibia fracture and anatrophic nephrolithotomy of staghorn calculi. On the fifth postoperative day, second operation was performed for nephrectomy due to perirenal hematoma. Two days later, third operation was performed for hemostasis because of the continuous bleeding. Coagulation tests showed positive DIC profiles of thrombocytopenia, hypofibrinogenemia, increased fibrin degradation products, and prolonged prothrombin time and thrombin time. The patient recovered uneventfully and discharged on the 59th postoperative day.
Blood Coagulation Factors ; Calculi ; Dacarbazine ; Disseminated Intravascular Coagulation* ; Fibrin ; Fibrin Fibrinogen Degradation Products ; Fibrinolysis ; Hematoma ; Hemorrhage* ; Hemorrhagic Disorders ; Hemostasis ; Humans ; Middle Aged ; Nephrectomy ; Postoperative Complications ; Prothrombin Time ; Thrombin Time ; Thrombocytopenia ; Tibia

No abstract available.
Congenital Abnormalities*

BACKGROUND: It has been documented that certain prognostic factors may affect the outcomes of the old aged victims by trauma. Considering that trauma is the sixth most common cause of death in people over the age of 65 years and there is a rapid growth of elderly population, it is paramount to understand the prognostic factors when dealing with geriatric trauma patients. Hypothesis and Goals : It can be hypothesized that the prognostic factors should be determined independently between populations being consisted of different races, countries, socio-economic states, cultures, or so on. Thus, study was designed to evaluate the factors affecting the outcomes of elderly Korean trauma patients. METHODS: One hundred forty six patients aged over 65 years were retrospectively reviewed, who visited the Emergency Canter of Korea University from January, 1997 to June, 1998. Of 146 patients, 7 were excluded due to discharge against advice or transfer to the other hospitals. Parameters analysed were age, sex, mechanism of injuries, body region injured, Injury Severity Score (ISS), previous medical illness, hospital morbidity, duration of hospital stay, and cost. Each patient was classified into improved or not-improved groups depending on the outcomes, and young-old or old-old group depending on the age. The factors affecting the hospital stay in improved patients were analyzed in the parameters of previous medical illness, hospital morbidity, multiple injuries, ISS, and age. All statistical tests were conducted with two-tailed levels of 0.05. RESULTS: Of 139 patients, the mean age was 74+/-7.1 years, mean ISS 9.3+/-7.26, mean hospital stay 27+/-27.1 days. Most commonly injured body region was the extremities due to fall from a level surface. Rate of previous illness showed 0.94 medical diseases per person and were aggravated after trauma in 39 patients (60.9%). Hospital morbidity rate was 0.46 incidents per person. There were no differences in age and duration of hospital stay between the improved and the not-improved group. Substantial differences were noted in affected body region, incidence of previous illness, and hospital morbidity between the groups (p=NS). Not-improved group had higher ISS (p<0.05). ISS, previous illness and hospital morbidity affected the duration of hospital stay in the improved group. Hospital stay was 40+/-25.1 days in patients with ISS over 6 while 6+/-8.6 days in those with ISS 5 (p<0.05). Hospital stay in the improved was 26+/-26.9 days while 31+/- 24.8 days in the improved old-old group (P=NS). Hospital stay in the young-old minor trauma (ISS5) patients with previous illness and hospital morbidity was 26+/-10.1 days while 4+/-7.3 days in those without previous illness and hospital morbidity (p<0.05). CONCLUSION: Previous medical illness and hospital morbidity, not age, are predictive of outcomes of geriatric trauma patients with respect to hospital stay. As most of the hospital morbidity was a trauma-induced aggravation of previous medical illness and hospital morbidity contributing poor outcomes can be potentially avoidable, routine aggressive care far the geriatric trauma patients with previous medical illnesses is needed.
Aged ; Body Regions ; Cause of Death ; Continental Population Groups ; Emergencies ; Extremities ; Humans ; Incidence ; Injury Severity Score ; Korea ; Length of Stay ; Multiple Trauma ; Retrospective Studies

Between Aug. 1985 and Dec. 1995, among 18 patients with trauma of anterior urethra 7 were treated by an endoscopically guided primary urethral realignment under intravenous injection of analgesics. Of the 5 partial ruptures, 3 had excellent results without stricture from 2 months to 4 years (mean 13 months) and resulted in 23-37ml/sec maximal uroflow rate. Then 2 had focal urethral stricture, which could be easily treated with endoscopic internal urethrotomy. Before endoscopically guided primary urethral realignment was done, 6 urethral ruptures without pelvic bone fracture partial rupture 3 cases, complete rupture 3 cases) were performed suprapubic cystostomy and urethroplasty stepwise. We experienced urethral stricture in 6 cases, then performed endoscopic internal urethrotomy and urethroplasty. 4 cases of urethral rupture with pelvic bone fracture partial rupture 1 case, complete rupture 3 cases) were performed suprapubic cystostomy and primary urethroplasty, then there were urethral stricture in all 4 cases. This method offers simpler and more effective than conventional methods without pelvic bone fracture under intravenous injection of analgesics.
Analgesics ; Constriction, Pathologic ; Cystostomy ; Endoscopy ; Humans ; Injections, Intravenous ; Pelvic Bones ; Rupture* ; Urethra ; Urethral Stricture

No abstract available.
Thyroid Gland* ; Thyroid Nodule*

The proliferating activity of the cancer cells was estimated in 67 superficial bladder tumors (26 pTa and 41 pT1) by the silver-binding nucleolar organizer regions(AgNORs), proliferating cell nuclear antigen(PCNA) and flow cytometric DNA analysis. the clinical variances, AgNORs count, PCNA positivity and the incidence of aneuploidy showed no correlation with recurrence statistically. But cytology, grade and PCNA positivity had statistical significance for progression (p<0.0.05). Especially cytology and PCNA positivity showed independent predictive values in multiple logistic regression analysis. We analyzed the values with above mentioned method including intravesical chemotherapy. None of above showed correlation with recurrence statistically. Cytology, grade, BCG therapy and PCNA positivity had statistical significance for progression( p <0.05). But none of those showed statistical significance in multiple logistic regression analysis. In summary, AgNORs count, PCNA positivity and the incidence of aneup1oidy may not have the value of prognostic factor to predict recurrence and/or progression if include intravesical chemotherapy.
Aneuploidy ; DNA* ; Drug Therapy ; Incidence ; Logistic Models ; Mycobacterium bovis ; Nucleolus Organizer Region* ; Proliferating Cell Nuclear Antigen* ; Recurrence ; Urinary Bladder Neoplasms* ; Urinary Bladder*