1.Treatment of Squamous Cell Carcinoma in Extremity & Trunk.
The Journal of the Korean Bone and Joint Tumor Society 2012;18(1):7-13
PURPOSE: The purpose of this study is to compare general survival rate and survival rate according to expectable prognostic factors by analyzing the result of treating a patient of squamous cell carcinoma. MATERIALS AND METHODS: From Mar. 1999 to Feb. 2011, 151 patients were pathologically confirmed as squamous cell carcinoma of limbs and body in our hospital, and among those patients, 51 patients underwent the surgical treatment. This study included 41 patients who underwent the surgical treatment and were followed-up for more than 12 months. The mean age of population was 64.4 years. 31 males and 10 females were included. Wide excision with following skin grafts or flaps for reconstruction (29 cases) was mostly performed, but amputation (12 cases) was also performed for cases with extremities where resection margin was difficult to obtain and cases with neural or vascular invasion. 8 patients underwent chemotherapy or radiotherapy after resection, and 33 underwent the operation only. Stages were classified by AJCC Classification, survival rate was calculated by Kaplan-Meier method and survival rate of groups was compared by Log-rank test. For the expectable prognostic factors related to survival rate, location of primary lesion, cause of disease, pathologic grade, staging, surgical method, additional anticancer therapy were examined and each survival rate was compared. RESULTS: The average follow-up period was 65.2 (12-132) months. Thirty patients survived out of 41 patients till last follow up. The overall survival rate in 5 years was 77%. Three cases (7.3%) had local recurrence, and 7 cases (17.0%) had metastasis. The average period of recurrence from operation was 27 (18-43) months. Possible prognostic factors such as location of primary lesion, cause of disease, pathologic grade, staging, additional anticancer therapy showed no significant difference in survival rates. However, patients with amputation showed significantly lower survival rate than those with wide excision. CONCLUSION: In analysis the results of treating 41 cases of squamous cell carcinoma, the overall 5-year survival rate was 77%. And, among the several prognostic factors, only the surgical method was significant statistically.
Amputation
;
Carcinoma, Squamous Cell
;
Extremities
;
Female
;
Follow-Up Studies
;
Humans
;
Male
;
Neoplasm Metastasis
;
Recurrence
;
Skin
;
Survival Rate
;
Transplants
2.Primary Bone Tumors in Hindfoot.
The Journal of the Korean Bone and Joint Tumor Society 2013;19(1):1-8
PURPOSE: Primary bone tumors of hindfoot are uncommon compared with other locations, and there have been few large-group studies. This study was designed to analyze the characteristics and the clinical results of the primary bone tumors of hindfoot. MATERIALS AND METHODS: Forty five cases in 44 patients who have been diagnosed from 1989 to 2011 were reviewed. The minimum follow-up period was 1 year. We retrospectively reviewed the medical records and images. RESULTS: Twenty six cases were male and 18 cases were female. Mean follow-up period was 33.1 months and mean age was 25.1 years. Forty four cases were benign and 1 case was malignant. Thirty six cases occurred in calcaneus and 9 cases were in talus. The most common benign bone tumor was simple bone cyst (20 cases), followed by intraosseous lipoma (12 cases), and chondroblastoma (4 cases). In calcaneus, there were 18 cases of simple bone cyst, and 12 cases of intrasosseous lipoma. In talus, there were 3 cases of chondroblastoma, 2 cases of simple bone cyst, and 2 cases of intraossesous ganglion. Many patients with hindfoot bone tumors presented with pain, but some were found accidentally. Patients received surgical procedures, such as curettage and bone graft, open reduction and internal fixation, tumor resection, and below knee amputation. CONCLUSION: Primary bone tumors of hindfoot are rare and can be misdiagnosed as ankle sprain or contusion. Although most are benign, malignant tumors cannot be ruled out, so early diagnosis and appropriate treatment is important.
Animals
;
Ankle
;
Bone Cysts
;
Calcaneus
;
Chondroblastoma
;
Contusions
;
Curettage
;
Early Diagnosis
;
Female
;
Follow-Up Studies
;
Ganglion Cysts
;
Humans
;
Knee
;
Lipoma
;
Male
;
Medical Records
;
Retrospective Studies
;
Sprains and Strains
;
Talus
;
Transplants
3.The State and Medicine in Korea in the 20th Century : Traditional Medicine.
Journal of the Korean Medical Association 1999;42(12):1160-1166
No abstract available.
Korea*
;
Medicine, Traditional*
4.Analysis of Treatment Results of Malignant Melanoma.
The Journal of the Korean Bone and Joint Tumor Society 2011;17(1):30-35
PURPOSE: This study was designed to evaluate the treatment results of malignant melanoma and to analyze the factors influencing prognosis. MATERIALS AND METHODS: Thirty one cases of malignant melanoma were included in this study. They were treated in our hospital surgically, medically and immunologically from January 1996 to December 2005, and were followed more than 5 years. We compared 5 year survival rate (5YSR) according to the age, gender, anatomical site, depth of tumor, TNM stage, involvement of lymph node and immuno-chemotherapy. RESULTS: Overall 5YSR was 80.6%. 5YSR of the age group below 65 years was 89.7% and 66.7% for the age group over 65 (p=0.033). 5YSR for men was 75% and 90.9% for women. 5YSR according to the site of occurrence showed 66.7% in upper extremities, 89.5% in lower extremities, and 66.7% in other site. 5YSR was 100% for the Clark level below III and 62.5% for the level above IV (p=0.032). 5YSR was 53.8% for lymph node metastasis group and 100% for non-lymph node metastasis group (p=0.021). CONCLUSION: We concluded that early diagnosis and wide excision was the most important in treatment of malignant melanoma. The prognostic fractors of malignant melanoma were age, depth of tumor (Clark's stage) and metastasis of lymph node.
Early Diagnosis
;
Female
;
Humans
;
Lower Extremity
;
Lymph Nodes
;
Male
;
Melanoma
;
Neoplasm Metastasis
;
Survival Rate
;
Upper Extremity
5.The Early Result of Anterior Rotational Osteotomy in the Treatment of Osteonecrosis of the Femoral Head.
Sae Dong KIM ; Duk Seop SHIN ; Woo Seok JANG
Yeungnam University Journal of Medicine 1994;11(2):284-292
In transtrochanteric rotational osteotomy to treat osteonecrosis of the femoral head, the necrotic superior anterior femoral head is rotated anteriorly around the longitudinal neck axis so that the weight bearing force is transferred to the intact posterior surface. The ratio of transposed intact articular surface of the femoral head to the weight-bearing surface of the acetabulum on postoperative anteroposterior view of the hip roentgenograph is the most important indicator of the prognosis. During the period from December 1992 to June 1994, we treated 31 hips in 28 patients who were indicated for the anterior rotational osteotomy among the patients of osteoncrosis of the femoral head. Among the patients, male were 27 and female was one. Age distribution was from 13 to 62 years old and mean age was 44.3. According to the Ficat and Arlet classification, II A was most in number as 16 II B was 7 and III was 8. As their etiolgic factors, alcohol was most in number as 18, steroid was 3, idiopathic was 5 and trauma was 2. The mean rate of the intact area of the posterior part of the femoral head to the total articular surface on the preoperative lateral view of the hip roentgenograph was 41.8%. The mean ratio of transposed intact articular surface of the femoral head to the weight bearing surface of the acetabulum was 53.8% Fixation devices were screws or dynamic hip screw.
Acetabulum
;
Age Distribution
;
Classification
;
Female
;
Head*
;
Hip
;
Humans
;
Male
;
Neck
;
Osteonecrosis*
;
Osteotomy*
;
Prognosis
;
Weight-Bearing
6.The Use of Ender Nails in Treatment of the Tibial Shaft Fractures
Duk Seop SHIN ; Sae Dong KIM ; Joo Chul IHN
The Journal of the Korean Orthopaedic Association 1989;24(3):708-714
Fractures of the tibial shaft are the most common among the long bone fractures, and have much difficulty in treatment due to their enumerous complications. 21 patients with fracture of the tibial shaft were treated with Ender nails under the image intensifier at the Department of Orthopedic Surgery, Yeungnam University Hospital from December 1986 to September 1988. The result was sumarized as follows :1. The average age was 37.3 and the number of male was three times of the female. The most common cause was traffic accident. 2. 14 cases out of 22 were closed fracture and the remsining 5 were open. The comminuted and segmental fractures were 17(77.3%) and the most common fracture site was middle one third. 3. Aversge interval from injury to operation was 6.5 days and in 15 cases show the associated injurues. 4. The mean duration of the bone union was 17.6 weeks and in 2 cases show the delayd union. 5. 10 complications were noted such as shortening, varus deformity, delayed union, ankle motion limitation, nail irritation, and soft tissue infection.
Accidents, Traffic
;
Ankle
;
Congenital Abnormalities
;
Female
;
Fractures, Bone
;
Fractures, Closed
;
Humans
;
Male
;
Orthopedics
;
Soft Tissue Infections
;
Tibia
7.Intraosseous Lipoma A report of four cases.
Hye Jeong CHOI ; Mi Jin GU ; Joon Hyuk CHOI ; Duk Seop SHIN ; Kil Ho CHO
Korean Journal of Pathology 1999;33(6):467-470
Intraosseous lipoma is a very rare primary tumor of the bone. We report four cases of intraosseous lipoma. The patient ranged in age from 34 to 59-year-old (median age: 35 year-old). There were three men and one woman. All of four cases presented with pain. The involved bones were calcaneus in two cases, tibia in one case and ilium in one case, respectively. In all cases plain x-ray film revealed well-defined lytic lesion. Their size ranged 2 to 4.5 cm (mean size: 3.5 cm). Histologic examination showed mature adipose tissue. Three cases showed secondary changes such as atrophic bone, fat necrosis, fibrosis, dystrophic calcification, and reactive ischemic bone formation. The clinicopathologic and roentgenographic correlation are necessary in establishing correct diagnosis of this tumor.
Adipose Tissue
;
Calcaneus
;
Diagnosis
;
Fat Necrosis
;
Female
;
Fibrosis
;
Humans
;
Ilium
;
Lipoma*
;
Male
;
Middle Aged
;
Osteogenesis
;
Tibia
;
X-Ray Film
8.Treatment of Developmental Dislocation of the Hip in Walking Age.
Se Dong KIM ; Jae Hyuk JANG ; Dong Chul LEE ; Duk Seop SHIN
Yeungnam University Journal of Medicine 1996;13(2):211-224
The patients of developmental dislocation of the hip(DDH) are almost found after walking age because of early diagnosis of DDH in younger children is not easy. A controversy still exists as to the relative value of closed and operative management in the treatment of a child who has reached walking age. This study is a report of the results of 16 patients(17 cases) in developmental dislocation of the hip who have visited our hospital at the age of 9 months to 3 years old, and have been followed more than 12 months (12-112 months) on review of plain radiographs and arthrograms. The results were as follows 1. The age at diagnosis was 16.4 months(9-31 months) in average. The methods of treatment were conservative for 8 cases, and operation for 4 cases and secondary operation for 5 cases who were failed with conservative therapy. 2. By Severin's radiologic grade, the result was good in 4 cases, fair in 3 cases and poor in 1 case in conservative treatment. In operative treatment, fair was in 2 cases and poor in 2 cases. In secondary operative -patients who were failed with conservative therapy, good was in 2 cases, fair in 2 cases and poor in 1 case. 3. Avascular necrosis of femoral head was developed in 3 cases. 4. In the good reduction as determined by arthrogram according to Race and Herring, we can get a favorable result in conservative treatment, and in the poor reduction as determined by arthrogram, the better
Child
;
Continental Population Groups
;
Diagnosis
;
Dislocations*
;
Early Diagnosis
;
Head
;
Hip*
;
Humans
;
Necrosis
;
Walking*
9.Surgical Treatment for Pathologic Fracture of Skeletal Metastatic Lesion of the Proximal Femur: Comparison of Clinical Outcomes for Prosthetic Joint Replacement and Osteosynthetic Fixation.
Duk Seop SHIN ; Ui Sik KIM ; Hae jun KWAK ; Young Jin KO
The Journal of the Korean Bone and Joint Tumor Society 2011;17(1):44-50
PURPOSE: To compare clinical outcomes of the tumor prosthetic replacement and osteosynthetic fixation for pathologic fracture of skeletal metastatic lesion of the proximal femur. MATERIALS AND METHODS: From 1994 May to 2009 May, medical records of 22 patients who underwent tumor prosthetic replacement with tumor resection (group 1) and 15 others (16 hips) who underwent osteosynthetic fixation without tumor resection (group 2) were reviewed. The mean age of overall patients were 59 (group 1) and 60 (group 2). Mean follow up periods were 23 and 11 months. The oncological and functional results were evaluated with Kaplan-Meier methods and Musculoskeletal Tumor Society (MSTS) scoring system, 1993. The statistical evaluation was assessed with Log rank test and t-test. RESULTS: The mean survival periods were 24 months in group 1 and 11months in group 2. The 1 year survival rates were 86% in group 1 and 50 % in group 2, and 2 year survival rates were 29.7% in group 1 and 9.4% in group 2. The mean MSTS functional score were 26.4 (19-30), 87.9% in group 1 and 15.3 (10-23), 51.0% in group 2. CONCLUSION: The results of tumor resection and prosthetic replacement in selected cases was better than osteosynthetic fixation without tumor resection for metastatic bone tumors around proximal femur in oncological and functional aspects.
Femur
;
Follow-Up Studies
;
Fractures, Spontaneous
;
Humans
;
Joints
;
Medical Records
;
Survival Rate
10.Percutaneous K-wire fixation of supracondylar fracture of humerus in children.
Duk Seop SHIN ; Jong Chul AHN ; Se Dong KIM ; Dong Woo LEE
Yeungnam University Journal of Medicine 1993;10(2):400-408
During the period from March 1990 to November 1993, 22 children with diplaced supracondylar fracture of humerus were treated by closed reduction and percutaneous K-wire fixation at department of Orthopaedic surgery in Yeungnam University. All fracture were treated with closed reduction under the general anesthesia and percutaneous pinning. After the fracture was internally fixed, intraoperative anteroposterior reontgenograms of each distal humerus were compared. Only anatomical reduction ensured good result,, because the main cause of late cubitus varus was medial tilting of distal fragment. We could follow up 10 patients more than one year. By Flynn's criteria, satisfactory result were obtained in 9 of the 10. Unsatisfactory one had a limitation in flexion of elbow joint, but had no problem in cosmetic feature. In short term follow up of 7 patients, 5 patients had a satisfactory result, too. There were no neurovascular complication and hospitalization was shortened to 11.4 days. Closed reduction and percutaneous pinning provided stabillity, vascular safty, simplified management, reduced hospital stay. This is safe and reliable technique for obtaining and maintaining an exellent reduction.
Anesthesia, General
;
Child*
;
Elbow Joint
;
Follow-Up Studies
;
Hospitalization
;
Humans
;
Humerus*
;
Length of Stay