Kaposi's sarcoma was first descrided by Kaposi in 1872 as an idiopathic multiple hemorrhagic sarcoma. Its clinical features revealed to be erythematous red or purple macule started out, and developing into palpable dome-shaped nodules. Etiology is not defined to detail at present. Kaposi's sarcoma is classified to 4 categories; Classical, African, Epidemic and Transplant type. Epidemic or AIDS categories is found approximately 20 % of all AIDS and has strong predilection for head and neck region. The first case of Kaposi's sarcoma observed in patients with kidney transplants was reported in 1969. Kaposi's sarcoma now accounts for 5% of all tumors associated with transplanted patients and alteration of the immunosuppression may have played a key role in these recipients. The most common site of Kaposi's sarcoma in transplanted patients are extremities but rare in head and neck area. We report a case of Kaposi's sarcoma on the hard palate in the kidney transplantation patient.
Extremities ; Head ; Humans ; Immunosuppression ; Kidney ; Kidney Transplantation ; Mouth* ; Neck ; Palate, Hard ; Sarcoma ; Sarcoma, Kaposi*

OBJECTIVES: This study uses meta-analysis methodology to examine the statistical consistency and importance of random variation among results of epidemiologic studies of occupational electromagnetic field exposure and leukemia. METHODS: Studies for this meta-analysis were identified from previous reviews and by asking researcher active in this field for recommendations. Overall, 27 studies of occupational electromagnetic field exposures and leukemia were reviewed. A variety of meta-analysis statistical methods have been used to assess combined effects, to identify heterogeneity, and to provide a single summary risk estimate based on a set of simiar epidemiologic studies. In this study, classification of exposure metircs on occupational epidemiologic studies are reported for (1) job classification (20 individual studies); (2) leukemia subtypes (13 individual studies); and (3) country (27 individual studies). RESULTS: Results of this study, an inverse-variance weighted pooling of all the data leads to a small but significant elevation in risk of 11% (OR=1.11, 95% CI : 1.06~1.16) among 27 occupational epidemiologic studies. Publication bias was assessed by the 'fail-safe n' that may be not influence for all combined results exception a few categories, ie, "power station operators" and "electric utility workers" by job classification on occupational study. And all combined odds ratio results were similar for fixed-effects models and random-effects models, with slightly higher risk estimates for the random-effects model in situations where there was significant heterogeneity, ie, Q-statistic significant (p<.05). CONCLUSIONS: We found a small elevation in risk of leukemia, but the ubiquitous nature of exposure to electromagnetic fields from workplace makes even a weak association a public health issue of substantial power to influence the present overall conclusion about relationship between electromagnetic fields exposure and leukemia.
Classification ; Electromagnetic Fields* ; Epidemiologic Studies ; Leukemia* ; Magnets* ; Odds Ratio ; Population Characteristics ; Public Health ; Publication Bias

Recently the high-density porous polyethylene[Medpor(r)]has been used as a new orbital implant for the reconstruction after enucleation or evisceration to reduce the implant exposure and migration, and to increase the prosthesis motility. We performed 16 cases of Medpor(r) orbital implantation combined with enucleation, evisceration or secondary orbital implantation between November 1997 and December 1998. Then, we investigated the postoperative complication, prosthesis motility, fibrovascular ingrowth pattern into the implant and MCP[Medpor(r) Coupling Post]insertion to increase the prosthesis motility for the average of 10 months [range, 6 to 18 months]. We performed a total of 16 cases of implantation :10 cases after evisceration, 5 cases after enucleation and 1 case as secondary implantation. There were 3 cases of conjunctival dehiscence, 1 case of retrobulbar hemorrhage and 1 case of superior sulcus deformity. There were no implant exposure, migration or severe inflammation. Postoperative prosthesis motility was found in 13 cases as good, 2 cases as fair and 1 case as poor. After enucleation or evisceration, Medpor(r) orbital implantation showed no significant difference from the previous porous orbital implants in postoper ative complication, prosthesis motility and fibrovascular ingrowth into the implant. It appears to be a good orbital implant because of the lower material cost, convenience in the operative procedure and other advantages. But long-term follow-up may be necessary for the detection of clinical change, the complication of MCP insertion and for the evaluation of the fibrovascular ingrowth pattern after Medpor(r) implantation.
Congenital Abnormalities ; Follow-Up Studies ; Inflammation ; Orbit* ; Orbital Implants* ; Postoperative Complications ; Prostheses and Implants ; Retrobulbar Hemorrhage ; Surgical Procedures, Operative

No abstract available.
Arthroplasty, Replacement, Hip*

PURPOSE: The author evaluated the clinical and radiological results after wearing the medial arch supports in children. MATERIALS AND METHODS: 103 patients who had symptomatic flat feet were evaluated from march, 2002 to may 2009. All patients wore the medial arch supports according to the symptoms. We measured parameters at weight-bearing radiographs before and after medial arch support were worn. We also evaluated the clinical scores using the AOFAS score. RESULTS: Mean age of patients was 97 months (11-204 months), all foot of patients involved bilaterally. Mean talo-first metatarsal angle of right foot was 17.7+/-9.4 and left foot was 19.96+/-9.5 degrees at AP radiograph in pre-wearing state. Mean calcaneal pitch angle of right foot was 12.0+/-5.3 and left foot was 11.9+/-5.8 degrees at lateral radiograph in pre-wearing state. Mean talo-first metatarsal angle of right foot was 14.4+/-8.05 and left foot was 13.1+/-8.77 degrees at AP radiograph in post-wearing state. Mean calcaneal pitch angle of right foot was 16.4+/-5.75 left foot was 16.5+/-5.6 degrees at lateral radiograph in post-wearing state. The radiographic angles between pre-wearing and post-wearing state were statistically significant (p<0.05). Mean pre-wearing AOFAS hindfoot score was 66.7+/-9.25, midfoot score was 60.0+/-9.34 forefoot score was 57.1+/-11.8. Mean post-wearing AOFAS hindfoot score was 73.2+/-9.73, midfoot score was 68.1+/-10.1, forefoot score was 67.2+/-11.4. The forefoot score was highest improving scores among the AOFAS scores. CONCLUSION: From our study, we concluded that medial arch support was effective for symptomatic flat feet of children in radiological and clinical results from our study.
Child ; Flatfoot ; Foot ; Humans ; Metatarsal Bones ; Weight-Bearing

From June 1990 to December 1998, 792 kidney transplantations were performed at Asan Medical Center. 436 cases(55M) were from living-related donors, 139 cases(17.6%) were from living-unrelated donors and 217 cases(27.4%) were from cadaveric donors. The results of the trasnplantation were analyzed according to the various factors known to influence the outcome of transplantation. In living transplants, the overall patients survival rate was 98.2% at 1 year and 95.8% at 5 years, the corres-ponding allograft survival rate was 96.9 and 86.1N. In cadaveric transplants, the overall patients survival rate was 94.3% at 1 year and 94.3% at 5 years, the corresponding allograft survival rate was was 90.296 and 84.8%. In living transplants, donor age(>50yrs), recipient age(>50yrs), ABO compatability, pretrans-plant blood transfusion, diabetic history had no effect on allograft survival rate. But HLA DR cornpa-tability, serum creatinine(2.5mg/dL) at discharge and rejection history had effect on allograft survival(p<0.05). In living-related transplants, 5 year allograft survival rate was 100% at HLA identical group and 86% at HLA haplomatched group. But the statistical significance was not found(p=0.052). In cadaveric transplants, donor age(>50yrs), recipient age(>50yrs), ABO compatability, HLA DR match, diabetic history, pretransplant transfusion had no effect on allograft survival. But serum creatinine at discharge(>2.5mg/dL) and posttransplant rejection had effect on allograft survival.
Allografts ; Blood Transfusion ; Cadaver ; Chungcheongnam-do* ; Creatinine ; Humans ; Kidney Transplantation ; Survival Rate ; Tissue Donors

A 77-year-old woman was admitted to this hospital for evaluation of chest pain for 3 days. On physical examination, icteric sclerae, inspiratory crackles on both lower lung field and normal heart sounds were observed. Electrocardiograms showed pathologic Q waves with ST elevations in the precordial leads(V1-V4). Chest X-rays showed mild pulmonary edema with anteroseptal wall akinesia. Cardiac enzyme studies were compatible with AMI. Hematologic investigation revealed severe thrombocytopenia and microangiopathic hemolytic anemia. Coagulation profiles were normal. Coombs test, sucrose lysis test, anti-platelet antibody and antinuclear antibody were all negative. Urinalysis showed albuminuria(+++) and microscopic hematuria. Initial therapy with aspirin, nitrate, morphine and prednisolone was started. Ten hours after admission, she developed agitation, aphagia and confusion with progression to coma. Computed tomography of the brain was normal. Five units of fresh frozen plasma were infused. After one day, platelet counts slightly increased. But cardiogenic shock ensued and she died despite cardiopulmonary resuscitation. AMI has not been reported in association with TTP. This patient had no risk factors for coronary artery disease and no previous history of angina. TTP was clinically diagnosed with confidence by excluding other known cause of microangiopathic hemolytic anemia with thrombocytopenia. Coronary angiogram and bone marrow examination could not be performed due to a rapidly fatal course. The etiology of AMI in this patient was not confirmed, but clinical evidence strongly supported etiologic association with TTP.
Aged ; Anemia, Hemolytic ; Antibodies, Antinuclear ; Aspirin ; Bone Marrow Examination ; Brain ; Cardiopulmonary Resuscitation ; Chest Pain ; Coma ; Coombs Test ; Coronary Artery Disease ; Dihydroergotamine ; Electrocardiography ; Female ; Heart Sounds ; Hematuria ; Humans ; Lung ; Morphine ; Myocardial Infarction ; Physical Examination ; Plasma ; Platelet Count ; Prednisolone ; Pulmonary Edema ; Purpura, Thrombotic Thrombocytopenic ; Respiratory Sounds ; Risk Factors ; Sclera ; Shock, Cardiogenic ; Sucrose ; Thorax ; Thrombocytopenia ; Urinalysis

No abstract available.
Arthritis* ; Immunoblastic Lymphadenopathy*

Between 1987 and 1992, 86 tibial fractures were treated with the Ilizarov external fixator at Gyeong-Sang National University Hospital and Okpo Hospital. The mean follow-up period was 31.4 months. Sixty-six were open fractures and twenty were closed fractures with severe comminution. In 66 open fractures, there were 9 Gustilo type I, 10 type II, and 47 type III fractures. Of 66 open fractures, 22 had bone defects ranged from 2cm to 17cm and 16 had extensive loss of soft tissue. Twenty-two bone defects were treated with cancellous bone grafts in 8 cases, bifocal osteosynthesis with bone graft in 12 cases, and trifocal osteosynthesis with bone graft in 2 cases. Thirty-four extensive soft tissue defects were treated with split-thickness skin graft, musculocutaneous flap, soft tissue transportation with ring used in bifocal, trifocal osteosynthesis, and acute shortening of fracture site. Of 20 closed fractures, 14 were treated with cancellous bone graft for decreasing union time and 6 were treated with monofocal compression without bone graft. The mean time to union was 20.5 weeks in closed fractures, and 35.4 weeks in open fractures. Of 40 complications, 12 were knee and ankle joint contractures, 12 were soft tissue and bone infections of pin tract, 5 were refracture, 5 were angular deformities of 10 degree or more, 5 were delayed union, and 2 were nonunion. According to Tucker's classification, the results were graded as excellent in 31, good in 38, fair in 12, and poor in 5 cases. Primary or secondary bone graft is necessary for early bony union and anatomical reduction combined with bone graft could prevent the complications of delayed union and nonunion.
Ankle Joint ; Classification ; Congenital Abnormalities ; Contracture ; External Fixators ; Follow-Up Studies ; Fractures, Closed ; Fractures, Open ; Ilizarov Technique ; Knee ; Myocutaneous Flap ; Skin ; Tibia ; Tibial Fractures ; Transplants ; Transportation

Interlocking and Ender nail fixations have been widely used for the surgical treatment of diaphyseal fractures of femur. Interlocking nail could give advantage of high stability to unstable, cominuted fractures. It requires, however, advanced technique and exposure to radiation harzard, often complicated by further comminution, displacement, breakage of drill bit or loosening of locking screws. Ender nail, on the contrary, is easier in procedure without reaming, thereby maintaining endosteum and requiring short operation time. It, however, cannot avoid complications of shortening, rotational deformity, migration of nails, etc. This study aimed at comparative evaluation of the clinical results of two different nailings(23 Interlocking and 19 Ender nails) performed from March 1987 to March 1993. The study materials were 42 femoral fractures out of 41 adult patients with the followed-up between one and seven years(average 3.5 years). The results are summarized as below: 1. Fracture occurred mostly in the mid-diaphysis(81%) and the Type III comminution(63%) was most common according to the Winquist-Hansen classifiaction. 2. The operative time averaged ninty five minutes in Interlocking nailing, while sixty minutes in Ender nailing. The blood loss was negligible in both techniques. 3. Fluoroscopic assessment after insertion of the nails revealed that Interlocking gave superior stability to Ender nail, while Ender nail produced earlier callus formation(7.5 weeks in average) than Interlocking nail(9.0 weeks in average, p < 0.05). It took both nails average eighteen weeks to obtain clinical union(p>0.05). 4. Interlocking nail was complicated by loosening of locking screws in two, angulation in one, breakage of drill bit in one cases. Ender nail showed protrusion in two, limb shortening in three, rotational deformity in three cases respectively. There was neither operative infection nor nonunion.
Adult ; Bony Callus ; Congenital Abnormalities ; Extremities ; Femoral Fractures ; Femur ; Humans ; Operative Time