The cliniopathological analysis was done on the 104 cases of malignant melanoma diagnosed at the Seoul National University Hospital (SNUH) from 1984 to 1993. The basic clinical data and the pathological items were based on the New Mexico Melanoma Registry Worksheet. The results were as follows. The male to female ratio was 1 : 0.79. Primary cutaneous melanoma was more common in the male (M : F=1 : 0.56) but primary extracutaneous melanoma with slight female dominancy (M : F=1 : 1.25). The peak age was the 6th decade in both cutaneous and extracutaneous malignant melanoma. In 66% (35 cases) of primary cutaneous malignant melanoma, the primary site was located in the acral area (including cases of acral lentiginous and nodular type), of which 63% (41% of total cutaneous melanoma) was acral lentiginous type. Major components of tumor cells were epithelioid. Clark's level of tumor was III or more at the time of the first visit in the majority of the cases (85%). The incidence rate of extracutaneous melanoma was 34.6% (36 cases) among the primary melanoma, and the eyeball (17.3%) was the most prevalent organ. All these features suggest that the racial difference between the Korean and the Caucasian is evident and also that etiologic role of sun damage is not quite marked in the Korean. We also suggest that an early detection program is very important to cure this malignant tumor.
Female ; Humans ; Incidence ; Male ; Melanoma* ; New Mexico ; Seoul ; Solar System

BACKGROUND: It has been reported that in 62.5% of cases of incurable cancer pain, the complaint is due to myofascial pain syndrome. Trigger point injections using dibucaine hydrochloride help patients with such cancer pain. This study evaluated the efficacy of trigger point injections for alleviating pain in patients with advanced cancer. METHODS: Twenty patients with advanced cancer who had a life expectancy of 6 months or less and had been diagnosed with myofascial pain syndrome were treated with trigger point injections. Prior to treatment, a Visual Analog Scale (VAS) was used to measure the resting pain level and discomfort upon application of pressure on the site of pain. These values were compared with last treatment measurements. RESULTS: The mean pre-treatment VAS scores for pain at rest and upon application of pressure on the pain site were 7.3 and 9.0, respectively. These scores decreased significantly to 1.95 and 3.2, respectively, after the treatment (P<0.05). CONCLUSION: Trigger point injection is an alternative and effective pain control modality for advanced cancer patients with myofascial pain syndrome.
Dibucaine ; Humans ; Life Expectancy ; Myofascial Pain Syndromes ; Trigger Points ; Visual Analog Scale

No abstract available.
Diagnosis* ; Hemophilia A* ; Molecular Biology* ; Polymorphism, Restriction Fragment Length*

Bilateral diaphragmatic paralysis(BDP) is a rare disorder, which can be secondary to spinal cord injury, motor neuron disease, myopathy, noninfectious polyneuropathy, infection, iced saline cardioplegia performed during cardiac surgery, or idiopathic causes. there may be typical presentations such as dyspnea, paradoxical respiratory movement, and hypercapnic respiratory failure. It needs to exclude above secondary causes to consider idiopathic bilateral diaphragmatic paralysis. We report a 51-years-old man who presented with idiopathic bilateral diaphragmatic paralysis combined with acute pancreatitis. We couldnt, find out the association of these two clinical conditions. The patient was improved by mechanical ventilation.
Dyspnea ; Heart Arrest, Induced ; Humans ; Motor Neuron Disease ; Muscular Diseases ; Pancreatitis* ; Polyneuropathies ; Respiration, Artificial ; Respiratory Insufficiency ; Respiratory Paralysis* ; Spinal Cord Injuries ; Thoracic Surgery

No abstract available.

A case of congenital rhabdomyoma of the heart in a 5-month-old Korean infant is described. The patient presented with a congenital supraventricular tachyarrhymia that was detected in utero by fetal sonography. The tumor was multiple, but no obvious association with tuberous sclerosis complex was demonstrated. Microscopic examination revealed classic "spider cells" with rich glycogen content. Ultrastructurally, the cells contained numerous leptofibrils, clumped Z band material, and desmosome-like cell junctions. The case is a second documented case of cardiac rhabdomyoma in this country, and its presentation as an etiological factor of supraventricular tachycardia is a very unusual manifestation.
Female ; Heart Neoplasms/complications/*congenital/ultrastructure ; Humans ; Infant ; Rhabdomyosarcoma/complications/*congenital/ultrastructure ; Tachycardia, Supraventricular/*congenital/etiology

Severe ankle sprain secondarily leads to chronic lateral ankle instability in 20-30%. Many surgical procedures have been presented for reconstruction of the lateral ankle instability, but controversy still remains for the ideal surgical option. Brostrom procedure or its modifications have been widely used but they have some limitations for the instabilities for the over-weight, physically high demanding patients and especially for significantly deficient or attenuated ligaments. Moreover the tenodesis procedures using peroneus brevis tendon are non-anatomical and sacrifice important lateral stabilizing tendon. Therefore recently, many reconstructive procedures for lateral ankle instability utilizing free allograft or autograft tendon have been introduced to anatomically stabilize the lateral ligaments to various degrees.
Animals ; Ankle ; Collateral Ligaments ; Humans ; Ligaments ; Sprains and Strains ; Tendons ; Tenodesis ; Transplantation, Homologous

PURPOSE: End-stage ankle arthritis is frequently combined with ankle-hindfoot deformity or ankle instability and therefore additional surgical procedures are often required when performing total ankle arthroplasty. We report the short term clinical and radiographic results of the total ankle arthroplasty with/without the combined adjunctive surgical procedures. MATERIALS AND METHODS:The study is based on the 17 ankles (16 patients) of end-stage ankle arthritis that were treated with HINTEGRA(R)Total ankle prosthesis (Newdeal, Lyons, France) total ankle arthroplasty (TAA) from 2004 to 2007 with at least 12 months follow-up. The combined adjunctive procedures as well as the VAS pain score, AOFAS score, radiographic measurements and patient satisfactions were evaluated. RESULTS:Average follow-up period was 29 months (13~55 months) , and the age was average 62 years (39~75 years) old. Among total of 17 ankles, varus deformity and lateral ankle instability were found in 4 cases and 3 cases respectively. Twenty additional procedures such as Achilles triple hemisection (9), calcaneal displacement osteotomy (4) and lateral ankle ligament reconstruction (3) were performed in adjunct to TAA in 13 ankles. VAS pain score improved from preoperative average 8.4 (7~10) to 2.0 (0~5) and the AOFAS functional score improved from 41.8 points (13~71 points) to 90.6 (77~100 points) at final follow-up. Ninety-four percent of the patients were satisfied with the surgery. CONCLUSION: We confirmed that many adjunctive combined surgical procedures are often necessary in addressing the end-stage ankle arthritis (74%) with total ankle arthroplasty. We also achieved quite good clinical and radiographic short term results, although the long term follow-up study with larger number of cases are needed in the future.
Animals ; Ankle ; Arthritis ; Arthroplasty ; Congenital Abnormalities ; Displacement (Psychology) ; Follow-Up Studies ; Humans ; Ligaments ; Osteotomy ; Prostheses and Implants

Solid pseudopapillary tumor (SPT) of the pancreas is a rare tumor that typically affects young women without causing significant clinical symptoms. No case of SPT in an old man has been reported in South Korea, and such cases are very rare worldwide. We report a 70-year-old man with SPT of the pancreas with multiple organ metastasis. Although surgical resection is the treatment of choice for SPT, we decided not to treat, considering his age and the disease severity.
Aged ; Diagnosis ; Female ; Humans ; Korea* ; Neoplasm Metastasis ; Pancreas*

We report a severe case of hyponatremic encephalopathy in a 38 year old schizophrenic patient with polydipsia that was very likely precipitated by hydrochlorothiazide given for the accompanied hypertension in this patient. On admission via emergency room, this patient's electrolyte imbalances include not only hyponatremia but also hypokalemia, hypomagnesemia and metabolic alkalosis, which have been well known as the complications of thiazide diuretics. Fortunately, this patient recovered from comatose condition with the treatment of hyponatremia at the correction rate of about 0.5mEq/L/hr in addition to potassium and volume replacements. However, this case gives us the warning that the presence of hyponatremic condition such as polydipsia should be ruled out before thiazide diuretics prescribed for patients with schizophrenia, and other electrolytes imbalance in addition to hyponatremia as the complications of thiazide diuretics should be looked for the simultaneous treatment for them.
Adult ; Alkalosis ; Coma ; Electrolytes ; Emergency Service, Hospital ; Humans ; Hydrochlorothiazide ; Hypertension ; Hypokalemia ; Hyponatremia ; Polydipsia ; Potassium ; Schizophrenia ; Sodium Chloride Symporter Inhibitors