No abstract available.
Humans ; Hypocalcemia* ; Infant, Newborn ; Prognosis*

A nineteen year-old boy with progressive enlargement of the joints and distal extremities, clubbing, coarse facial features and hyperhidrosis was investigated. In physical examination, thickening of the scalp with furrowing (cutis verticis gyrata) and greasy thickening of skin (pachyderma) was prominent. His endocrine profile was normal. Radiological studies demonstrated bilateral symmetrical periosteal new bone formation with acroosteolysis and incidental microadenoma of pituitay gland. After extensive investigation to exclude systemic and endocrine causes, the patient was diagnosed as pachydermoperiostosis (PDP). PDP is a rare syndrome manifested clinically by finger clubbing, extremity enlargement, hypertrophic skin changes, and periosteal bone formation. The pathogenesis of the disorder has not been clarified though few endocrine abnormalities were seen. To aware of these clinical phenotype would help to differentiate PDP from acromegaly.
Acro-Osteolysis ; Acromegaly ; Extremities ; Fingers ; Humans ; Hyperhidrosis ; Joints ; Male* ; Osteoarthropathy, Primary Hypertrophic* ; Osteogenesis ; Phenotype ; Physical Examination ; Scalp ; Skin ; Young Adult*

As is well known, myxoma of the heart is very rare(incidence 0.03%), constituting nearly 50% of all primary cardiac tumors. It is important because it can be abolished by surgical removal but usually fatal if unrecognized or untreated. Recently a wider use of echocardiogram as the screening test of valve lesions can be expected to increase the number of myxomas found preoperatively. We have experienced a case of bilateral atrial myxoma which simulated mitral valvular disease clinically and had typical three cardinal manifestations such as obstructive, embolic and constitutional symptoms. The patients was 39 years old woman. The left atrial myxoma was diagnosed preoperatively by echocardiography and cardiac angiography and the remainder during open heart surgery under the E.C.C. Both of them were removed successfuly and confirmed as typical myxoma microscopically. This is the first case report of bilateral atrial myxoma in Korea to our knowledge.
Adult ; Angiography ; Echocardiography ; Female ; Heart ; Heart Neoplasms ; Humans ; Korea ; Mass Screening ; Myxoma* ; Thoracic Surgery

No abstract available.
Orientia tsutsugamushi* ; Rickettsia* ; Ulsan*

PURPOSE: We investigated whether myocardial SPECT had additional usefulness to clinical, functional or surgical indices for the preoperative evaluation of cardiac risks in noncardiac surgery. MATERIALS AND METHODS: 118 patients (M: F=66:52, 62.7+/-10.5 years) were studied retrospectively. Eighteen underwent vascular surgeries and 100 nonvascular surgeries. Rest T1-201/stress Tc-99m-MIBI SPECT was performed before operation and cardiac events (hard event: cardiac death and myocardial infarction; soft event: ischemic ECG change, congestive heart failure and unstable angina) were surveyed through perioperative periods (14.6+/-5.6 days). Clinical risk indices, functional capacity, surgery procedures and SPECT findings were tested for their predictive values of perioperative cardiac events. RESULTS: Peri-operative cardiac events occurred in 25 patients (3 hard events and 22 soft events). Clinical risk indices, surgical procedure risks and SPECT findings but functional capacity were predictive of cardiac events. Reversible perfusion decrease was a better predictor than persistent decrease. Multivariate analysis sorted` out surgical procedure risk (p=0.0018) and SPECT findings (p=0.0001) as significant risk factors. SPECT could re-stratify perioperative cardiac risks in patients ranked with surgical procedures. CONCLUSION:: We conclude that myocardial SPECT provides additional predictive value to surgical type risks as well as clinical indexes or functional capacity for the prediction of preoperative cardiac events in noncardiac surgery.
Death ; Electrocardiography ; Heart Failure ; Humans ; Multivariate Analysis ; Myocardial Infarction ; Myocardial Ischemia ; Perfusion ; Perioperative Period ; Retrospective Studies ; Risk Factors ; Tomography, Emission-Computed, Single-Photon*

The pancreatic pseudocyst as a sequela of pancreatitis or pancreatic trauma can occur at any site in the abdomen. Its detection seems to be increasing with modern imaging tools such as abdominal ultrasound or abdominal CT scanning. But recently, we experienced a case of a pseudocyst due to a ruptured pancreatic pseudocyst which was misdiagnosed as a simple hepatic cyst by abdominal ultrasonography or abdominal CT scan. A 12-year-old male presented with recurrent epigastric pain during the past 4 years. On the abdominal ultrasound and abdominal CT scan, there was an 8x7.5 cm sized sharply defined thin-walled cyst in the left lobe of the liver. First, percutaneous (cather) drainage guided by ultrasonography was done. An exploratory laparotomy was performed because of signs of hemoperitoneum. A 8x7.5 cm sized cyst was found at the left subhepatic space, which communicated with another smaller cystic lesion in the pancreatic head. Microscopic finding of the cyst showed infiltration of inflammatory cells and granulation tissue without ephithelial lined cells which is compatible to a pseudocyst. So we report this case with a review of literatures.
Abdomen ; Child ; Diagnostic Errors* ; Drainage ; Granulation Tissue ; Head ; Hemoperitoneum ; Humans ; Laparotomy ; Liver ; Male ; Pancreatic Pseudocyst* ; Pancreatitis ; Tomography, X-Ray Computed ; Ultrasonography

The pedicled fillet flap concept has been successfully applied in both the upper and lower extremities for the treatment of difficult wound. In cases of inevitable extremity amputation, the transfer of pedicled flap from the amputed part is possible. In such substance, it is possible to obtain the pedicled fillet flap from the amputed limb to provide stump coverage. We experienced two cases of below-knee amputation due to severe flame burn which the stump was covered with island pedicled sole-fillet flap.
Amputation Stumps* ; Amputation* ; Burns ; Extremities ; Knee* ; Lower Extremity ; Surgical Flaps ; Wounds and Injuries

It is indispensable to cover the skin defect when bone or tendon is exposed. In case of inevitable amputation of an extremity, it is possible to harvest a free flap from the amputed limb for providing coverage of the other wound. This technique allows immediate wound coverage without the morbidity of an additional donor site. We experienced an electrical burn case with inevitahle wrist disarticulation and successfully treated soft tissue defect of ankle using free vascularized flap.
Amputation ; Ankle* ; Burns ; Disarticulation ; Extremities ; Free Tissue Flaps ; Hand* ; Humans ; Skin ; Tendons ; Tissue Donors ; Wounds and Injuries ; Wrist

Apert described acrocephalosyndactly as a clinical entity in 1906. The classic description of this syndrome includes patient with a combination of acrocephaly and syndactyly of either fingers, toes or both. More than 200 cases have been reported in the world literature. Authors experienced on case of the classic pattern of Apert syndrome and treated surgically for syndactyly. This one case was reported on this paper with brief review of the relevant literatures.
Acrocephalosyndactylia ; Craniosynostoses ; Fingers ; Humans ; Syndactyly ; Toes

A clinical review was performed on 64 cases of the foot drop treated by transferof the Posterior Tibialis tendon to the dorsum of the foot at Taegu Presbyterian Hospital during the period from January, 1965 to December, 1971. The follow-up result of 42 cases were obtained from 13 weeks to 4 years and 8 months. The result are summarized as follows. 1. Among 63 patients, there were 46 males and 17 females, ranging 12 to 57 years old of age. 2. The cause of foot drop were peroneal nerve palsy due to leprosy in 61 cases, anterior poliomyelitis in 2 cases, and traumatic peroneal palsy in 1 case. 3. Of 42, cases which follow-up study was done, the degree of active dorsiflexion of the ankle were 90 degree or more in 29 cases (69.0%) and range of active movement was 25 degree or more in 31 cases (73.8%). 22 cases (52.4%) had active dorsiflexion of the ankle which was 90 or more in degree and range of active movement of the ankle which was 25 degree or more. 4. Iterosseous route was used in 26 cases and circumtibial route in 38 cases. Their end results revealed slight better in the latter method. 5. The major causes of complication were detachment at insertion site in 7 cases (53.8% of total failure). weak motor power of the Posterior Tibialis in 4 cases, and adhesions in 2 cases.
Ankle ; Daegu ; Female ; Follow-Up Studies ; Foot ; Humans ; Leprosy ; Male ; Methods ; Paralysis ; Peroneal Nerve ; Poliomyelitis ; Protestantism ; Tendons