PURPOSE: To analyze the clinical features and treatment outcome of Langerhans' cell histocytosis. MATERIALS AND METHODS: From August 1996 to June 2013, 28 patients who histologically proven with LCH were analyzed of medical records, radiography, pathologic character retrospectively. RESULTS: A total of 28 cases of LCH including 22 child has been reported. Onset age was 0.6 to 51 years old, occurred in the average age was 14.8 years. Follow-up period was 6 months to 134 months average was 44.6 months. The M:F ratio was 2.5:1. The initial symptoms was pain in 18 cases, 5 cases of pathologic fracture, 3 case of palpable mass, 1 case of discovered by accident in radiography, 1 case of torticollis. In radiological examination osteolysis was seen all cases, 7 cases showed a periosteal reaction, 1 case showed soft tissue extension. Clinical type of all cases were eosinophilic granuloma. 25 cases were classified as unifocal disease and 3 cases were multifocal single systemic diseases. In all cases, incisional biopsy was performed. After histologic confirmed, 14 cases was treated with curettage or surgical excision of the lesion and the other 14 cases were followed up without treatment. There is no death during follow up period. 11 cases has no radiological improvement after 3-6 months observation, intralesional steroid injection was performed. CONCLUSION: Patients with LCH who has rapid systemic onset is very rare, so if you meet the young children who suspected LCH, you shoulder avoid the examination which cause excessive radiation exposure to the young patient. In order to confirm the diagnosis of disease, biopsy is needed. Close observation after confirmed by histological method will bring the satisfactory results. But the patients who had pathologic fracture or wide bone destruction already may need curettage and bone grafting to lesion or internal fixation. The lesion which has no radiological improvement after 3-6 months observation or appear with pain interferes daily life may need local steroid injection as a good treatment.
Age of Onset ; Biopsy ; Bone Transplantation ; Child ; Curettage ; Diagnosis ; Eosinophilic Granuloma ; Follow-Up Studies ; Fractures, Spontaneous ; Histiocytosis, Langerhans-Cell ; Humans ; Medical Records ; Osteolysis ; Radiography ; Retrospective Studies ; Shoulder ; Torticollis ; Treatment Outcome*

No abstract available.

Five cases of tennis elbow seen during the time period from Jaunary 1983 to January 1985 had operative treatment. Of the five clinical cases, four elbows in three patients were treated with Nirschl and Pettrone operation. This operative technique included exposure of the extensor carpi radialis brevis, excision of the identified lesion, and repair. The following results were obtained. 1. Correct analysis of the patient's emotional stability was essential prior to undertaking surgical procedure for tennis elbow. 2. The results of Nirschl and Pettrone operation were graded as excellent in three elbows and fair in one.
Elbow ; Humans ; Mortuary Practice ; Tennis Elbow ; Tennis

No abstract available.
Anterior Cruciate Ligament* ; Rupture*

BACKGROUND: Acute appendicitis is very not uncommon disease and has many difficulties in the diagnosis of disease. So we should evaluate the significance of diagnosis by "MANTRELS" score which is very simple and easily accessible tools in patients of right lower quadrant abdominal pain. METHODS: We studied 164 patients initially complainted of right lower quadrant abdominal pain from Jan 1 to Jun 30. 1997 in emergency department of Yeungnam university hospital. At first, "MANTRELS" scores was calculated and we evaluated the final diagnosis, surgically operated or not, transferred or not, etc, retrospectively. Next, two groups were divided each that group A was surgically operated, group B was not surgically operated. And then the statistical significance and accuracy rate according to scores and cut-off values in each groups were evaluated. RESULTS: All 164 patients was admitted in emergency department of Yeungnam University hospital and male to female ratio was 1:0.98, mean ages was 35.3 years old. The incidences according to each items of "MANTRELS" were as follows; most in Tenderness and Shift to left, Migration of pain in group A and most in Tenderness and Anorexia. Nausea in group B. As the results according to each scores in both group, score 8; 25 cases, score 7; 14 cases in group B were showed and the correlation coefficients was 0.979. And as the results according to cut-off value in both groups. it's sensitivity and negative predictability. false negative, positive joint probability were decreased and others were increased as the cut-off values, respectively. The diagnostic weight was most highest(75.0%) when the cut-off value was 7. CONCLUSION: The authors would authorize that "MANTRELS" score is very simple scoring system and have diagnostic values in differentiating between acute appendicitis and other diseases complaining of right lower quadrant abdominal pain.
Abdominal Pain ; Anorexia ; Appendicitis* ; Diagnosis* ; Emergency Service, Hospital ; Female ; Humans ; Incidence ; Joints ; Male ; Nausea ; Retrospective Studies

PURPOSE: To determine the accuracy of automated computer aided volumetry for simulated small pulmonary nodules at computed tomography using various types of phantoms MATERIALS AND METHODS: Three sets of synthetic nodules (small, calcified and those adjacent to vessels) were studied. The volume of the nodules in each set was already known, and using multi-slice CT, volumetric data for each nodule was acquired from the three-dimensional reconstructed image. The volume was calculated by applying three different threshold values using Rapidia(R) software (3D-Med, Seoul, Korea). RESULTS: Relative errors in the measured volume of synthetic pulmonary nodules were 17.3, 2.9, and 11.5% at -200, -400, and -600 HU, respectively, and there was good correlation between true volume and measured volume at -400 HU (r=0.96, p<0.001). For calcified nodules, relative errors in measured volume were 10.9, 5.3, and 16.5% at -200, -400, and -600 HU, respectively, and there was good correlation between true volume and measured volume at -400 HU (r=1.03, p<0.001). In cases involving synthetic nodules adjacent to vessels, relative errors were 4.6, 16.3, and 31.2 % at -200, -400, and -600 HU, respectively. There was good correlation between true volume and measured volume at -200 HU (r=1.1, p<0.001). CONCLUSION: Using computer-aided volumetry, the measured volumes of synthetic nodules correlated closely with their true volume. Measured volumes were the same at each threshold level, regardless of window setting.
Cone-Beam Computed Tomography ; Seoul

Subepidermal calcified nodule(SCN) is a form of calcinosis cutis which is usually present as a single small, raised, hard nodule with verrucous surface. A 13-year-old girl presented with a 10-month history of a ricegrain-sized, hard, yellowish white papule on both upper eyelids. The lesions were asymptomatic and had increased slowly in size. An excisional biopsy specimen of the left upper eyelid showed acanthosis and narrow pointed rete ridges of the epidermis, and closely aggregated deposition of basophilic material in the uppermost dermis. The material in the dermis did not stain with von Kossa. It was confirmed as calcium deposition by staining with alizarin red S which is far more specific for calcium than the von Kossa stain.
Adolescent ; Basophils ; Biopsy ; Calcinosis ; Calcium ; Dermis ; Epidermis ; Eyelids ; Female ; Humans

Acquired port-wine stain is rare. It mimics a congenital port-wine stain morphologically but the pattern of onset is acquired after birth. It represents a progressive ectasia of vessels located in the superficial vascular plexus. The exact mechanism is unknown but some reported cases have occurred after trauma. We herein report five cases of acquired port-wine stains and they were idiopathic in nature.
Dilatation, Pathologic ; Parturition ; Port-Wine Stain*

Upper gastrointestinal(UGI) bleeding was critical disease that was commonly found in emergency department and needed more early diagnosis and rapid treatment for decreasing mortality and morbidity. It's causes and frequencies here affected by many factors, but the majorities were caused by peptic ulcers and esophageal-gastric varices. With development of economy and medical services, new drugs and endoscopic interventions, the treatment of patients with UGI bleeding was more improved. So I would like to evaluate the change of causes and frequencies of UGI bleeding and the associated clinical findings. A total of 1,546 patients presented with UGI bleeding in emergency department of Yeungnam university hospital during the five years from Jan. 1991 to Dec. 1995 were clinically reviewed by charts and compared with previous seven years report from Jan. 1984 to Dec. 1990 in the same hospital. The ratio of male to female was 6.1:1 and slightly increased in comparison with previous seven years. The incidences in 6th and 5th decades were highest(54.4%) as like as previous seven years. Age distribution of duodenal ulcer bleeding, Mallory-Weiss tear and acute gastric mucosal lesion were developed in lower decades than the others. The causes of UGI bleeding were caused by esophageal varix(45.4%), peptic ulcer(38.8%), Mallory-Weiss tear(4.3%), gastric cancer(3.8%), others(3.1%), acute gastric mucosal lesion(2.7%), undetermined causes(1.8%) in defending order of frequencies. The proportion of esophageal varices was increased from 36.6% to 45.4%, but that of peptic ulcer was relatively decreased from 47.6% to 38.8%. And the annual distribution of varices was increased, however the annual distribution of peptic ulcers was increased. Although the ranking of annual distribution of gastric ulcers and duodenal ulcers were not changed compared to previous study and the frequency of gastric ulcers was increased since 1992, but additional follow-up was needed. Seasonal variations were found that upper gastrointestinal bleeding was increased in fall and peptic ulcer bleeding was increased significantly in summer and fall, however, varix bleeding was less frequent in summer time as like as previous seven years. Emergency endoscopic examination was performed within 6 hours far 54.5%, 24 hours for 90.8% and this reacts were to be like previous results, 57.5% and 90.7% respectively. Findings of emergency endoscopic examination were active bleeding focus(21.2%), blood clot(7.9%), exposed vessels(13.3%), flat blood spot(6.4%) and lesion without evidence of bleeding(51.3%). Endoscopic findings of active bleeding were easily seton when examination was perfomed within 24 hours. Blood transfusion was performed in 67.3% with average 2.1 units. When the causes of bleeding were due to varix and marginal ulcer, more amounts of blood were transfused than the others. In previous seven years, blood transfusions were performed in 71.2% with average 5 units and more amounts of blood were transfused in gastric cancer and varix bleeding.
Age Distribution ; Blood Transfusion ; Duodenal Ulcer ; Early Diagnosis ; Emergencies ; Emergency Service, Hospital ; Esophageal and Gastric Varices ; Female ; Follow-Up Studies ; Hemorrhage* ; Humans ; Incidence ; Male ; Mallory-Weiss Syndrome ; Mortality ; Peptic Ulcer ; Seasons ; Stomach Neoplasms ; Stomach Ulcer ; Varicose Veins

The incidence of conjoined twins is so rare that few anesthesiologists have an opportunity of managing them. Especially in Korea, there are only a few reports describing the anesthetic management for surgical separation of newborn conjoined twins. We experienced the successful anesthetic management for surgical separation of thoraco-xiphopagus conjoined twins without any particular problems. After applying the noninvasive monitors (ECG, pulse oximeter), one of the twins (twinA) with congenital heart disease was administered with intravenous ketamine for induction of anesthesia and intubated without neuromuscular blocker. Anesthesia was maintained with N2O-O2 and hand ventilation using Mapleson D breathing circuit. After maintaining airway of the twinA, the twinB was intubated and maintained with the same manner. Eighteen days after the separation procedure, the twinA with congenital heart disease died and the other one, twinB has been alive with normal growth and development.
Anesthesia ; Growth and Development ; Hand ; Heart Defects, Congenital ; Humans ; Incidence ; Infant, Newborn ; Ketamine ; Korea ; Neuromuscular Blockade ; Respiration ; Twins, Conjoined* ; Ventilation