This report is a clinical review of 58 patients suffering from frostbite, who were treated at the department orthopedic surgery, Seoul City Dong Bu Hospital from November 1982 to March 1985. The results are as follows: 1. The male to female sex ratio was 13.5:l. 2. The majority of the patients (72%) were decades between 30 and 50. 3. Frostbite began on November and registered the highest incidence in January, the lowest temperature of the year. 4. The most commonly affected region was the lower extremities, bilaterally. 5. The average duration of exposure in cold weather was 23 days, 6. The average hospitalization period was 84 days. 7. Among the 58 patients, 14 patients were treated by conservative treatment, 14 patients by closed amputation and 25 patients by open amputation.
Amputation ; Clinical Study ; Female ; Frostbite ; Hospitalization ; Humans ; Incidence ; Lower Extremity ; Male ; Orthopedics ; Seoul ; Sex Ratio ; Weather

A clinical study of traumatic amputation by railroad accidents was made an 124 patients with 154 amputee, who had been treated at Department of Orthopaedic Surgery, National Seoul Hospital, during the 4 years period from January 1976 to December 1979. The results of this study are as follows: 1. The ratio of male to female was 9 to 1. The 3rd decade of age group showed the hightest number of accident causalties, as much as 37.1%. 2. Causalties showes a maximum during the sprlng (37.1%) and a minimum during winter. 3. The most common injured sites of the amputee were B–K in 44 cases among 154 cases of the amputee. 4. Considering the number of the multiple amputee in 26 casee among 124 cases, frequently they developed in 2 sites with 22 cases, 3 sites with 4 cases. 5. The frequent fracture sites with combined amputation were 18 cases of the pelvic bone, 12 cases of femur in amputation of the lower extremity. 6. Our methods of treatment were debridement, debridement and primary skin closure, debridement with open amputation, circular amputation, closed amputation with skin graft, and closed amputation. 7. The major complications were phantom limb in 108 cases (70.1%), infection in 44 cases (28.6%). 8. The most frequent infectious agent was pseudomonas (16 cases).
Amputation ; Amputation, Traumatic ; Amputees ; Clinical Study ; Debridement ; Female ; Femur ; Humans ; Lower Extremity ; Male ; Pelvic Bones ; Phantom Limb ; Pseudomonas ; Railroads ; Seoul ; Skin ; Transplants

Primary hepatic carcinoid tumors are extremely rare although the liver is a frequent site of metastases from intestinal carcinoids. Recently we investigated a case of primary hepatic atypical carcinoid in a 47-year-old man who had infested with Clonorchis sinensis for 20 years. The resected right lobe of the liver was almost completely occupied by a huge tumor, measuring 20 x 19 x 12 cm. The cut surfaces of the mass were solid, soft and pale yellow, accompanied by several small satellite nodules, measuring up to 1.5 cm in diameter. Microscopically, the tumor consisted of polygonal to columnar cells with eosinophilic granular cytoplasm forming Lym-numerous small acini and large trabeculae. Their nuclei were round to polygonal with coarse stone chromatin, had obscure to small nucleoli and frequent mitoses. There were multiple necrotic foci of varing sizes. The surrounding dilated bile ducts contained several degenerating worms on in of Clonorchis sinensis. The tumor cells were argyrophil-positive but argentaffin-negative. Immunohistochemically, the tumor cells were positive for cytokeratin, chromogranin and somatostatin but were negative for CEA, AFP, insulin, glucagon, ACTH, growth hormone and volve-prolactin. Ultrastructually, the tumor cells contained variable-sized numerous electron dense of neurosecretory granules.
Male ; Humans ; Neoplasm Metastasis

The purpose of this study was to develop and test the validity of standardized Korean nomenclature of the Home Health Care Classification(HHCC), developed by Saba at the University of Georgetown. The four phases of the study were : (1) Two professors and 15 graduate students, who were taking a nursing intervention course, translated the HHCC into Korean. (2)12 nurses with various clinical backgrounds reviewed each nomenclature taking into consideration of the definition and activities, and the Delphi method was used to determine the best appropriate nomenclature for each term; (3)20 academic and clinical experts in nursing were given a questionnaire to rate the validity of each Korean nomenclature using a 5 point Likert scale ranging from very inappropriate to very appropriate; (4) Five members of the Korean Nurses Association Research Committee reviewed the survey results and determined the most appropriate Korean nomenclature for each term of the HHCC. Most of the nomenclatures had a score of more than 4.0, but several terms had a score lower than 4.0. They are Ambulation therapy(3.1.1), Anticipatory grieving(3.11), Sexual patterns alteration(3.17), Nursing care coordination(3. 22), Physical therapist service(3.22), Regular diet(3.33), and Instrumental activities of daily living(3.44). These research results will be included in the nursing vocabulary dictionary to be published by the Korean Nurses Association.
Classification* ; Delivery of Health Care* ; Humans ; Nursing ; Nursing Care ; Physical Therapists ; Vocabulary ; Walking ; Surveys and Questionnaires

Nursing Diagnosis has evolved in the guest to define nursing and its functions. But for the application to clinical practice an unified system of terminology that help nurses to assess selected data and identify potential or actual client problems is required. Consistent terminology that captures the real meanings of the nursing diagnosis makes oral and written communication more accurate and efficient. Already we had performed to deliver a Korean -translated version of the 98 nursing diagnoses through the process of content validity tests and translations, and additionally performed to deliver a Korean-translated version of another 17 nursing diagnoses. The list of 17 nursing diagnoses were reviewed by our research team and two linguists, one specialized in Korean and the other in English. 17 diagnoses were mailed to 719 subjects to test content validity from December 10, 1997 to January 24, 1998, Among 719 questionnaires, 185 were used for analysis. Total mean score of the diagnoses was 3.72 on the 5 point likert scale. The diagnoses that acquired less than 3.50 were 'Risk for altered parent/infant/child attachment'(3.28), 'Potential for enhanced organized infant behavior'(3.40), 'Potential for enhanced community coping' & 'Risk for disorganized infant behavior'(3.49). We suggest to conduct tests for validation of related factors and characteristics of these 17 Nursing Diagnosis.
Diagnosis ; Humans ; Infant ; Nursing Diagnosis* ; Nursing* ; Postal Service ; Translations ; Surveys and Questionnaires

Following the introduction of instrumentation for phacoemulsification and vitctomy, many other devices have been deaigned to perform the functions. In the past, there was a serious prblem that fluid flowed from the eye along the path of least resistance and the dutflow rate varied greatly with viscosity and consistency of material in the line. Recently a new computerized instrument the Heslin/Mackool Ocusystem that overcame these flow problems was developed and we studied about early experiences using this new helper. The results were as follows: 1. There was an advantage for time and place due to a single instrument and simple change from E.C.C.E. to vitrectomy. 2. The rupture of posterior capsule in aphakic group and the remained cortical material in pseudophakic group were the most common surgical complications during operation. 3. Descemet's membrane stripping was developed in a high rate due to the sharp titanum-covered cap of the handpiece for phacoemulsification. 4. The posterior capsule opacity was the most common postoperative complication in the group of visual acuity less than 0.5.
Descemet Membrane ; Phacoemulsification* ; Postoperative Complications ; Rupture ; Viscosity ; Visual Acuity ; Vitrectomy*

Hemangioblastomas comprise 1 to 2% of all intracranial neoplasm, and 8 to 12% of tumors within the posterior fossa. They are composed of admixtures of three different cell types; endothelial cells, pericytes and stromal cells. Although most hemangioblastomas arise sporadically, they are associated with von Hippel-Lindau disease in about 20% cases. We have experienced a case of multiple hemangioblastomas occuiing in the cerebellum, medulla oblongata and cervical spinal cord simultaneously in a 55-year-old male. He had complained of headache, dizziness, generalized weakness and gait disturbance for 2 weeks. The patient had neither specific family history nor increased hematocrit. MRI showed a nonenhancing cystic lesion with an enhancing mural nodule in the right cerebellar hemisphere and two separate enhancing nodules in the medulla oblongata and dorsal cervical spinal cord at the 5-6th. Grossly, the excised mass of the cerebellum, 2.5 x 2 x 1.8cm, was solid to partly cystic, and that of spinal cord, lcm in diameter, was mostly solid. Microscopically, the tumor was composed of thin-walled blood vessels in variable size and interspersed stromal cells. The stromal cells revealed dimorphic cytoplasm that were either homogeneous and eosinophilic, or clear and vacuolated. Immunohistochemically, the endothelial cells reacted positively for glial fibrfllaty acidic protein(GFAP) and vimentin. The stromal cells reacted diffusely positively for vimentin, focally positively for GFAP and S-100 protein near the periphery of the tumor, focally positivel for neuro specipic enolase(NSE), and negatively for lysozyme, desmin and chromogranin. Ultrastructurally, the stromal cells contained numerous microfilaments and lipid droplets.

Hemangioblastomas comprise 1 to 2% of all intracranial neoplasm, and 8 to 12% of tumors within the posterior fossa. They are composed of admixtures of three different cell types; endothelial cells, pericytes and stromal cells. Although most hemangioblastomas arise sporadically, they are associated with von Hippel-Lindau disease in about 20% cases. We have experienced a case of multiple hemangioblastomas occuiing in the cerebellum, medulla oblongata and cervical spinal cord simultaneously in a 55-year-old male. He had complained of headache, dizziness, generalized weakness and gait disturbance for 2 weeks. The patient had neither specific family history nor increased hematocrit. MRI showed a nonenhancing cystic lesion with an enhancing mural nodule in the right cerebellar hemisphere and two separate enhancing nodules in the medulla oblongata and dorsal cervical spinal cord at the 5-6th. Grossly, the excised mass of the cerebellum, 2.5 x 2 x 1.8cm, was solid to partly cystic, and that of spinal cord, lcm in diameter, was mostly solid. Microscopically, the tumor was composed of thin-walled blood vessels in variable size and interspersed stromal cells. The stromal cells revealed dimorphic cytoplasm that were either homogeneous and eosinophilic, or clear and vacuolated. Immunohistochemically, the endothelial cells reacted positively for glial fibrfllaty acidic protein(GFAP) and vimentin. The stromal cells reacted diffusely positively for vimentin, focally positively for GFAP and S-100 protein near the periphery of the tumor, focally positivel for neuro specipic enolase(NSE), and negatively for lysozyme, desmin and chromogranin. Ultrastructurally, the stromal cells contained numerous microfilaments and lipid droplets.

In vivo animal models are limited in their ability to mimic the extremely complex systems of the human body, and there is increasing disquiet about the ethics of animal research. Many authorities in different geographical areas are considering implementing a ban on animal testing, including testing for cosmetics and pharmaceuticals. Therefore, there is a need for research into systems that can replicate the responses of laboratory animals and simulate environments similar to the human body in a laboratory. An in vitro two-dimensional cell culture model is widely used, because such a system is relatively inexpensive, easy to implement, and can gather considerable amounts of reference data. However, these models lack a real physiological extracellular environment. Recent advances in stem cell biology, tissue engineering, and microfabrication techniques have facilitated the development of various 3D cell culture models. These include multicellular spheroids, organoids, and organs-on-chips, each of which has its own advantages and limitations. Organoids are organ-specific cell clusters created by aggregating cells derived from pluripotent, adult, and cancer stem cells. Patient-derived organoids can be used as models of human disease in a culture dish. Biomimetic organ chips are models that replicate the physiological and mechanical functions of human organs. Many organoids and organ-on-a-chips have been developed for drug screening and testing, so competition for patents between countries is also intensifying. We analyzed the scientific and technological trends underlying these cutting-edge models, which are developed for use as non-animal models for testing safety and efficacy at the nonclinical stages of drug development.

In vivo animal models are limited in their ability to mimic the extremely complex systems of the human body, and there is increasing disquiet about the ethics of animal research. Many authorities in different geographical areas are considering implementing a ban on animal testing, including testing for cosmetics and pharmaceuticals. Therefore, there is a need for research into systems that can replicate the responses of laboratory animals and simulate environments similar to the human body in a laboratory. An in vitro two-dimensional cell culture model is widely used, because such a system is relatively inexpensive, easy to implement, and can gather considerable amounts of reference data. However, these models lack a real physiological extracellular environment. Recent advances in stem cell biology, tissue engineering, and microfabrication techniques have facilitated the development of various 3D cell culture models. These include multicellular spheroids, organoids, and organs-on-chips, each of which has its own advantages and limitations. Organoids are organ-specific cell clusters created by aggregating cells derived from pluripotent, adult, and cancer stem cells. Patient-derived organoids can be used as models of human disease in a culture dish. Biomimetic organ chips are models that replicate the physiological and mechanical functions of human organs. Many organoids and organ-on-a-chips have been developed for drug screening and testing, so competition for patents between countries is also intensifying. We analyzed the scientific and technological trends underlying these cutting-edge models, which are developed for use as non-animal models for testing safety and efficacy at the nonclinical stages of drug development.