With the increasing number of the occupational accidents proportionate to the rapid development of modern culture, fractures of the hand have become one of the commonest fractures of the human body. The authors have reviewed 211 cases of injured hand in industry which were treated in the department of orthopedic surgery, InCheon Severance hospital from Jan. to Dec. in 1989. The following results were obtained; 1. The peak incidence was in the age group from 21 to 30 years in 87 cases (41.2%). Injured males outnumbered females predominantly by 92.9% vs 7.1%. 2. The hand injuries happened most commonly in the day time (from 8 oclock A.M. to 6 oclock P.M.) but there were no differences between month in the year. 3. Most of patients injured hand (73.9%) arrived at hospital within 1 hour after accidents. 4. The commonest cause of the injury was due to electric saw (21.9% ). 5. Of the 98 fracture cases left hand was more frequently involved than right hand and 64 cases monodigit and remained were polydigits. 6. 43 (32.6%) of total 132 fractured sites were index finger and 74 (56.1%) were distal phalanx. 7. The index finger was also most vulnerable to amputation (56.8% out of 44 amputation cases) and the most distal part was more vulnerable to amputation. 8. The most common method was primary closure and splint. The method of treatment was affected in part by the economic and social status of the patients. 9. In order to prevent hand injuries in industry, preventive policy should be established by improvement of working environments, machines and education.
Accidents, Occupational ; Amputation ; Education ; Female ; Fingers ; Hand Injuries ; Hand ; Human Body ; Humans ; Incheon ; Incidence ; Male ; Methods ; Orthopedics ; Splints

The incidence of the tuberculous osteomyelitis of bone and joint has been decreasing due to improvements in nutrition and medical treatment. However the resurgence of tuberculosis is observed with more frequency as an opportunistic infection. In Korea the incidence of the tuberculosis has been decreasing with rapid economic development, but it is still one of the common pathological conditions involving bone and joint. Tuberculos osteomyelitis confined only to the long bones without involving joints is very rare. The accurate diagnosis of the turberculos osteomyelitis of long bone is difficult, because of the low incidence, long duration and nonspecific radiological findings. We reviewed retrospectively a total of 521 consecutive bone and joint tuberculosis from March 1985 to December 1994. Thirty-eight cases were involved only long bones without inflicting joints. The mean duration of follow up was 16 months. The disease was most frequent in the third decade. Femur(45%) and metaphysic(79%) were the most commonly involved site of the tuberculous osteomyelitis of the long bone. Significant delay in the diagnosis and the initation of the treatment would have been avoided if the biopsy had been performed early. It was looked like that longer symptom duration, higher ESR, associated with pulmonary tuberculosis and inappropriate treatment resulted in recurrence. But when compared with primarily cured cases, these factors did not affect the recurrence statistically. In conclusion, the better results and prevention of the recurrence were observed in cases with early diagnosis, complete removal of the lesion and continuous antituberculous medication.
Biopsy ; Diagnosis ; Early Diagnosis ; Economic Development ; Follow-Up Studies ; Incidence ; Joints ; Korea ; Opportunistic Infections ; Osteomyelitis ; Recurrence ; Retrospective Studies ; Tuberculosis ; Tuberculosis, Osteoarticular ; Tuberculosis, Pulmonary

We compared the apparent accommodative power of 35 pseudophakic patients(43eyes) receiving posterior chamber lens in the bag with 34 normal persons(34eyes) by using AA-2000 accommodometer and evaluated the correlation between apparent accommodation and various factors like age, corrected visual acuity, refractive error, pupillary diameter, anterior chamber depth, or change of the anterior chamber depth in pseudophakic eyes. The mean apparent accommodative power was 1.41 +/- 0.62 diopter(D) in pseudophakic eyes and 1.58 +/- 1.71 D in phakic eyes and there was no stastistically significant difference between two groups. However, in cases younger than 55 years old, the apparent accommodative power was 1.34 +/- 0.48 D in 17 pseudophakic eyes and 2.51 +/- 2.31 D in 14 phakic eyes and there was statistically significant(p<0.05). Among the various factors, pupillary diameter appeared to be correlative to the apparent accommodative power in pseudophakic eyes. The smaller pupillary diameter, the greater accommodative power. Otherwise, another factors were not correlative to the apparent accommodative power.
Anterior Chamber ; Humans ; Middle Aged ; Pseudophakia ; Refractive Errors ; Visual Acuity

PURPOSE: We analyzed disease free survival and the prognostic factors of liposarcoma in the extremity. MATERIALS AND METHODS: Between 1994 and 2005, of 44 patients who were diagnosed and treated for liposarcoma of the extremity, 40 patients were restrospectively analysed. 13 out of 40 patients got postoperative radiotherapy. We examined local recurrence, distant metastasis and disease free 5-year survival rate. We also analyzed clinical prognostic factors, such as age, gender, size of tumor, prior unplanned excision, histologic type, surgical excision margin and postoperative radiotherapy respectively. RESULTS: There were 3 cases of local recurrence and 4 cases of distant metastasis. The disease free 5-year survival rate was 85.0%. 26 patients presented with myxoid, 8 well differentiated, 4 round cell, 1 pleomorphic and 1 dedifferentiated histology. The disease free 5-year survival rate of mixoid, well differentiated and round cell liposarcoma were 100.0%, 84.6% and 75.0% (p=0.419). The 5-year disease free survival rate was 90.6% in negative surgical margin (n=25) and 62.5% in positive surgical margin (n=15) (p=0.003). CONCLUSION: Our study suggests that surgical excision margin is significant prognostic factor for 5-year disease free survival rate.
Disease-Free Survival ; Extremities ; Humans ; Liposarcoma ; Neoplasm Metastasis ; Recurrence ; Survival Rate

A 18-month-old girl was seen because of an yellowish brown papular eruptions on the face, earlobes and neck of one year duration. A skin biopsy specimen revealed circumscribed cellular infiltrates composed of predorninantly pleornorphic histiocytes. Electron microscopy of biopsy material disclosed numerous worm like particles and coated vescles in limited area of the cell cytoplasm, consistent with the findinga described in benign cephalic histiocytosis. After six months of her first visit, the individual papules became flattened.
Biopsy ; Coated Vesicles ; Cytoplasm ; Female ; Histiocytes ; Histiocytosis* ; Humans ; Infant ; Microscopy, Electron ; Neck ; Skin

PURPOSE: Pigmented villonodular synovitis (PVNS) is a rare soft tissue tumor, which usually arises in larger joints, such as the knee. It has a high recurrence rate after surgical treatment. The purpose of this study is to evaluate and analyze the clinical results of diffuse-type pigmented villonodular synovitis cases that were treated with open total synovectomy. MATERIALS AND METHODS: Between 1994 and 2006, 21 patients who had diffuse-type pigmented villonodular synovitis were selectively reviewed. Among the 21 cases studied, 14 patients presented at the knee, 5 at the ankle, and 2 at the shoulder and elbow. The mean follow up period was 5.5 years (range, 36-157 months). The average age of the patients was 34 years consist of 7 men and 14 women. Clinical outcomes were analyzed retrospectively, including range of motion and complications. RESULTS: Open total synovectomy and adjuvant electrocautrization were done in all cases except one. During the regular follow-up period after the surgery, two patients showed symptoms of recurrence. After re-operation, only one case was pathologically confirmed as a recurrence. The patient who had partial synovectomy and the other patient who had second operation due to recur rence received additional radiation therapy. Clinical outcome scores were improved in every aspect (p<0.0001). 2 out of 14 Patients who had pigmented villonodular synovitis at the knee developed stiff knee after the surgery. CONCLUSION: After the open total synovectomy with electrocautrization, a low recurrence rate and satisfactory clinical outcome was achieved, observed in a minimum of 3 years of follow-up.
Animals ; Ankle ; Elbow ; Female ; Follow-Up Studies ; Humans ; Joints ; Knee ; Male ; Range of Motion, Articular ; Recurrence ; Retrospective Studies ; Shoulder ; Synovitis ; Synovitis, Pigmented Villonodular

No abstract available.
Carcinoma, Hepatocellular* ; Classification*

Cutaneous angiosarcorriias occur most commonly on the face and scalp of elderly individuals and are characterized by poor prognosis. We present a case of angiosarcoma in a 17-year-old boy not associated with any predisposing factors. The patient had three, ill-defined, 3 to 5 cm sized, erythematous, indurated subcutaneous nodules on the right upper extremity with a duration of 3 months. On histological examination, there were extravasated erythrocytes and irregular vascular channels lined by atypical endothelial cells in the dermis and subcutaneous tissue. The tumor cells appeared to dissect the collagen bundles. The patient was treated by wide surgical excision and post operative radiation therapy. However, 16 months after the operation, local recurrence was found to involve the close areas to the excision site on the right upper extremity and right axillary lymph nodes.
Adolescent* ; Aged ; Causality ; Collagen ; Dermis ; Endothelial Cells ; Erythrocytes ; Hemangiosarcoma* ; Humans ; Lymph Nodes ; Male ; Prognosis ; Recurrence ; Scalp ; Subcutaneous Tissue ; Upper Extremity*

In systemic rheumatic disease, marker antibodies such as anti-Sm, anti Scl-70 and anti Jo-1 are helpful in the diagnosis of disease, but in rheumatoid arthritis, the diagnosis is difficult due to the low sensitivity and specificity of the rheumatoid factor(RF). So, a new maker antibody with high sensitivity and specificity was needed. Recently, the antiperi- nuclear factor(APF) has gained particular attention. The results of the APF and RF test in 165 patients with rheumatoid arthritis, 77 patients with osteoarthritis, and 109 normal healthy persons, which were taken between January, 1994 through December 1994 were as follows; 1. The sensitivity, specificity, and predictive value of positivity of the RF test in patients with rheumatoid arthritis were 58.2%, 93.5%, and 95.0%, and that of the APF test were 72.1%, 94.6% and 92.2%, respectively. 2. The sensitivity, specificity and predictive value of positivity when combining the APF with the RF were 83.0%, 85.7%, and 92.6%, respectively. 3. The disease status of the patients correlated with intensity of the APF test, that is, the more severe the disease status, the higher intensity. In conclusion, the APF was useful in the diagnosis of rheumatoid arthritis, and may be used as an indicator of disease status. When combining test the APF with RF, the incidence of sero-negative rheumatoid arthritis decreased.
Antibodies ; Arthritis, Rheumatoid ; Diagnosis ; Humans ; Incidence ; Osteoarthritis ; Rheumatic Diseases ; Sensitivity and Specificity

Histiocytosis X patients present with a variety of clinical manifestations and outcomes. The principal difficulty in the establishment of a definite protocol for treatment is based on the poor understanding of the basic nature of this disease, the absence of reliable prognostic criteria, and the problems with nomenclature. The objectives of this study were to analysis the course of the disease and the results of treatment in patients who had Langerhans cell histiocytosis and to suggest prognostic factors and guidelines for management. We reviewed the thirty patient who had Langerhans cell histiocytosis for past ten years. These patients were followed for an average 4.8 years (range, excluding patients who died of the disease, two to eleven years). The patients were divided into tow group; eighteen patients who Langerhans cell histiocytosis localized in skeleton (group I) and twelve patients who had Langerhans cell histiocytosis disseminate in both skeleton and extra-skeleton (group II). Methods of treatment included curettage with or without bone graft, radiotherapy, or watchful observation alone in group I; chemotherapy, chemotherapy and radiotherapy, or curettage in group II. All eighteen patients in group I had a complete response to the therapy. Seventeen of these eighteen patients had not a recurrence by the time of the latest follow-up examination; one had a recurrence. Four of twelve patients in group II had a complete response to the therapy, four had a partial response, and four had no response. Eight of these twelve patients had a recurrence; four did not. Two patients in group II died of the disease. The significant prognostic factor was the extent of the disease, limited to the skeleton or not, and the age of onset was an indirect prognostic factor predictin multiple organ involvement.
Age of Onset ; Curettage ; Drug Therapy ; Follow-Up Studies ; Histiocytosis, Langerhans-Cell ; Humans ; Radiotherapy ; Recurrence ; Skeleton ; Transplants