No abstract available.
Thyroid Gland* ; Thyroid Neoplasms* ; Trachea*

BACKGROUND: Headache is a common symptom. It has not proved useful methods that the physician evaluated the alert patient who had headache. It needs the presence of predictors of intracranial pathology(ICP) which serves as influential factors in the indication of evaluation and hospitalization of patients. METHOD: So, in order to identify such factors, patient records were retrospectively analysed. 168 patients with the chief complaint of headache presented to the Emergency Department of Chonnam University Hospital during the period from January 1, 1995 to December 31, 1997. All were in an alert mental state and had no evidence of trauma and intoxication. RESULTS: 14 cases(8.3% revealed ICP. 41 cases(24.4% revealed systemic disease. The remainder of cases were divided among unclassified headaches(61 cases, 36.3%, tension headaches(30 cases, 17.9%, and migraine(22 cases, 13.1%. Comparison of ICP-positive and ICP-positive cases revealed that ICP-Positive Patients could be categorized by the following findings: (1) Presence of the focal sign through neurological examination, (2) age greater than 55 years, (3) presence of associated symptoms, (4) acute headache. These four manifestations were proven to be statistically significant as predictors of ICP. CONCLUSION: Although the positive predictive value of the above criteria is not perfect for the prediction of ICP, they are worthy of clinical consideration in alert patients presenting with headache.
Emergencies* ; Emergency Service, Hospital* ; Headache* ; Hospitalization* ; Humans ; Jeollanam-do ; Neurologic Examination ; Retrospective Studies

No abstract available.
Myxoma*

Anomalous development of the odonteid precess is an uncommon clinical occurence that can seriously impair the integrity af the atlantoaxial articulation. Absence of the odontoid process may be either congenital or acquired, but clinically the etiology is of little importance as the clinical signs and symptoms and the treatment are identical in both. We experienced a case of congenital absence of the odontoid process and good result was obtained from the posterior atlantoaxial fusion with hale-cast.
Odontoid Process

Recently, the frequency of meniscal injury of knee has been increasing due to increase of sports activities. It has been known that bucket handle tear is the most common type of the entire injuries of the meniscus. We found 127 cases of meniscal tears and experienced 42 cases of bucket handle tears in the arthroscopic findings from Jan. 1991 to April 1994 in our hospital. We analysed 31 cases which were followed up for at least 1 year. The purpose of this study is to analyse the locking history and frequency, to discuss the several types of bucket handle tear in arthroscopic view, to introduce three portal techniques using posteormedial or posterolateral portal to resect the meniscus, and to analyse our clinical results. So we concluded as follows. 1. Among the 31 cases, 23 cases(74%) had an episode of locking. 2. We found many different types of bucket handle tears in arthroscopic view and the most common type was complete tear in a classic type(11 cases). 3. We were able to resect the meniscal fragment very easily using posteromedial or posterolateral portal. 4. We obtained satisfactory results in 24 cases(77%).
Knee ; Sports ; Tears

Because most of the hip fracture is endemic to an elderly population, high mortality and morbidity has been encountered due to the fatal complications such as pneumonia, thromboembolism, and decubitus ulceration. So, it is essential to achieve early ambulation with complete reduction by strong interoal fixation divices in order to reduce those complications. As early as 25 years ago McCarroll remarked that this fracture must be considered “unsolved until the incidence of aseptic necrosis and nonunion could be diminished or abolished. Since that time improved reduction method and many new strong fixation divices such as Jewett nail-plate, Massie nail, and compression hip screw have been developed to achieve more accurate reduction and rigid immobilization. The following clinical results were shown by analysis of 117 cases of hip fractures experienced in the Department of Orthopedic Surgery, Seoul National University in the past 5 years from Jan. 1974 to Dec. 1978. 1. Femoral neck fractures were 67 cases and intertrochanteric fractures were 36 cases. 2. The most common cause of hip fractures was slip or fall (70.1%). 3. Incidence of femoral neck fracture was most frequent in the 6th decade, and that of the intertrochanteric fracture was in the 7th decade that is compared with 7th and 8th decade of Caucasian respectively. 4. Old hip fracture more than 3 weeks after trauma was in the 53.6%, and especially that of neck fracture was about 57%. 5. In the classification of the hip fractures, transcervical neck fracture was most frequent (70.1%), and unstable type (79.5%) in the intertrochanteric fracture. 6. Knowles pin was usually used in the stable neck fracture, while compression hip screw used in the unstable neck fracture. 7. Jewett nail-plate was usually used after Dimon-Hughston reduction, and compression hip screw after anatomical reduction in the unstable intertrochanteric fracture. But in the stable fracture either Jewett nail-plate or compression hip screw was usually used after anatomical reduction. 8. Endoprosthesis (26 cases), and total hip replacement arthroplasty (8 cases) were usually carried out in the old femur neck fracture treated by total hip arthroplasty was better than that by endoprosthesis. 9. Avascular necrosis was 13.3%, and nonunion 20% in the femur neck fracture. Nonunion was 12.5%, and delayed union 4.2% in the intertrochanteric fracture. With the above mentioned results, the following conclusion is obtained: 1. It is recommended that open reduction or arthriplasty of the hip should be performed if the closed reduction of the fracture of femoral neck is not adequate. 2. Graden alignment index is a good criteria for adequate reduction of femoral neck fracture. 3. Malunion induces the fate of femoral head to be avascular in the femoral neck fracture. 4. Compression hip screw is a good stabilizer for unstable intertrochanteric fracture. 5. The position of femoral endoprosthesis for delayed or inadequately reduced femoral neck fracture may be replaced by total hip replacement. The clinical result of total hip replacement is far better than that of femoral endoprosthesis In the cases of arthroplasty indication.
Aged ; Arthroplasty ; Arthroplasty, Replacement, Hip ; Classification ; Early Ambulation ; Femoral Neck Fractures ; Femur Neck ; Head ; Hip Fractures ; Hip ; Humans ; Immobilization ; Incidence ; Methods ; Mortality ; Neck ; Necrosis ; Orthopedics ; Pneumonia ; Pressure Ulcer ; Seoul ; Thromboembolism

Gynecomastia is a proliferation of glandular tissue of the breast in male and it is the most commonly observed breast disease amongst male patients associated with the negative impact on body image and social health of man. Although the medical therapy is an option with long-standing gynecomastia patients, the less than desirable effectiveness leads to the surgery. Although various techniques have been described for the correction of gynecomastia, the common technique of surgery has been performed with a circumareolar incision. However, this technique has been associated with undesirable complications such as a visible scar on the chest, areola inversion, and nipple necrosis. To remedy such complications, the transaxillary techniques were used in an attempt to avoid scar and the complication of the nipple areola complex. In this study, the surgery for the two patients with Simon’s grade III gynecomastia were performed using the pull-through technique and through the axillary incision. The result of the transaxillary subcutaneous mastectomy technique produced esthetic appearance with little complications.

Gynecomastia is a proliferation of glandular tissue of the breast in male and it is the most commonly observed breast disease amongst male patients associated with the negative impact on body image and social health of man. Although the medical therapy is an option with long-standing gynecomastia patients, the less than desirable effectiveness leads to the surgery. Although various techniques have been described for the correction of gynecomastia, the common technique of surgery has been performed with a circumareolar incision. However, this technique has been associated with undesirable complications such as a visible scar on the chest, areola inversion, and nipple necrosis. To remedy such complications, the transaxillary techniques were used in an attempt to avoid scar and the complication of the nipple areola complex. In this study, the surgery for the two patients with Simon’s grade III gynecomastia were performed using the pull-through technique and through the axillary incision. The result of the transaxillary subcutaneous mastectomy technique produced esthetic appearance with little complications.

BACKGROUND: ST segment elevation in patient with chest pain was seen in acute myocardial infarction and in numerous other non-infarction syndrome. The causes of non-infarction syndrome were left ventricular hypertrophy, BER(benign early repolarization), and left bundle branch block in cardiac origin and were hyperkalemia and hyperventilation syndrome in metabolic origin and were others. Furthermore, the differentiation of electrocardiogram between acute myocardial infarction and non-infarction syndrome was very difficult. So, we compared and analysed characteristics of ST segment elevation of acute myocardial infarction and non-infarction syndrome that suggested the clue of early diagnosis of coronary artery disease. METHOD AND MATERIALS: We retrospectively reviewed the electrocardiogram of 961 patients with chest pain who visited the emergency center from January 1999 to December 1999. Acute myocardial infarction was diagnosed by clinical finding, electrocardiogram, cardiac enzyme, echocardiogram, and myocardial spect. Left ventricular hypertrophy, BER, and left bundle branch block in cardiac origin of non-infarction syndrome were diagnosed by electrocardiographic criteria suggested by William J. Brady. Acute myocarditis, acute pericarditis, and hyperventilation syndrome were diagnosed by clinical finding. RESULTS: Among 961 patients with chest pain, 236(24.6%) patients manifested ST segment elevation who were diagnosed acute myocardial infarction in 162(68.6%) patients and non-infarction syndrome in 74(31.4%) patients. The causes of non-infarction syndrome in 74 patients were left ventricular hypertrophy(32:13.6%), BER(28:11.9%), left bundle branch block(11:4.7%), and others(3:1.3%). Three others were acute myocarditis, acute pericarditis, and hyperventilation syndrome. Electrocardiographic characteristics of ST segment elevation of non-infarction syndrome manifested almost same finding compared to William J. Brady' criteria. CONCLUSION: ST segment elevation in patient with chest with chest pain visited emergency department was seen in acute myocardial infarction(68.6%) and the other non-infarction syndromes(31.4%). Significant number of patients were not associated with acute myocardial infarction. Therefore, we must completely understand characteristics of ST segment elevation in acute myocardial infarction and the other non-infarction syndromes to diagnose fatal early coronary artery disease and to avoid unnecessary thrombolytic therapy.
Bundle-Branch Block ; Chest Pain* ; Coronary Artery Disease ; Early Diagnosis ; Electrocardiography ; Emergencies ; Emergency Service, Hospital ; Humans ; Hyperkalemia ; Hypertrophy, Left Ventricular ; Hyperventilation ; Myocardial Infarction* ; Myocarditis ; Pericarditis ; Retrospective Studies ; Thorax* ; Thrombolytic Therapy ; Tomography, Emission-Computed, Single-Photon

BACKGROUND: CD34 is a 115 kD glycoprotein which is expressed on hematopoietic progenitor cells. It is also known as an immunohistochemical marker of endothelial cells. OBJECTIVE: This study was designed to investigate the patterns of CD34 expression on: (1) cutaneous benign and malignant vascular tumors and (2) on the mature and immature vessels of pyogenic grauloma and capillary hemangioma. METHOD: We performed immunoperoxidase staining using a monoclonal anti-CD34 antibody (QBEND/10) on formalin fixed, paraffin-embedded sections of 23 benign and malignant cutaneous vascular tumors. RESULTS: The results are summerized as follows: 1. In 3 cases of nevus flammeus and 6 cases of carvernous hemangioma, vascular endothelial cells of all hemangiomas showed CD34 expressions. In 5 cases of angiokeratoma, endothelial cells of hemangioma, did not express CD34. 2. In all 5 cases of pyogenic granulomas and one case of capillary hemangioma, endothelial cells of mature vessels, endothelial cells near the well-formed lumina and endothelial cells showing intracellular lumina showed strong positivity for CD34, wbile endothelial cells far from the lumina and endothelial cells without lumina formation mostly showed negative staining for CD34. 3. One cese of Kaposis sarcoma showed focall positivity for CD34 both in endothelial cells of the small, well-formed vessels and spindle cells. Two cases of angiosarcoma showed CD34 expression only in endothelial cells of well-formed, normal appearing vessels, whereas atypical endothelial cells of tumor vessels and spindle cells were negative for CD34. CONCLUSION: CD34 could be a marker for endothelium in mature, well-differentiated vascular structures and may serve as a marker of lumen formation or differentiation of endothelial cells.
Angiokeratoma ; Endothelial Cells ; Endothelium ; Formaldehyde ; Glycoproteins ; Granuloma, Pyogenic ; Hemangioma ; Hemangioma, Capillary ; Hemangiosarcoma ; Hematopoietic Stem Cells ; Negative Staining ; Port-Wine Stain ; Sarcoma, Kaposi