Birth injury is defined as any condition that affects the fetus adversely during the labor or delivery. These traumatic injuries are subdivided further into those that from hypoxia and mechanical factors. We analyzed 57 patients of birth trauma including fractures, nerve injuries and head injuries during the delivery at Severance Hospital from Jan. 1980. to Dec. 1985 and 24 patients which were transfered from other hospital after delivery and the following results were obtained. 1. The rates of birth trauma in our hospital were 0.36% including clavicle fractures 0.27%,femoral fractures 0.006%, brachial plexus injuries 0.031%, skull fractures 0.025% and intracranial hemorrhage 0.025%. 2. The site of clavicle fractures were all middle one third, and 71.4% of cases were displaced. 3. Five cases of brachial plexus injuries were found, and each type was Erb's palsy 3 cases, Klumpke's palsy 1 case and whole arm palsy 1 case. Three cases were recovered completely and 2 cases were recovered partially. 4. Methods of delivery were as followed; normal delivery 50.6%, breech delivery 3.7%, forcep 7.5%, vacuum 21.0%, and Cesarian section 17.2%. 5. The primipara was 65.4% of the patients of birth trauma. 6. There was no statistical significances in the birth weight, head circumferences, and chest circumferences of the patients comparing to the normal infants.
Anoxia ; Arm ; Birth Injuries ; Birth Weight ; Brachial Plexus ; Brachial Plexus Neuropathies ; Clavicle ; Craniocerebral Trauma ; Fetus ; Head ; Humans ; Infant ; Intracranial Hemorrhages ; Paralysis ; Parturition ; Skull Fractures ; Surgical Instruments ; Thorax ; Vacuum

Acute pyogenic osteomyelitis is frequent in infants and children, usually hematogenous, and predominant in male. The etiology of acute osteomyelitis is of 3 types: hematogenous, direct innoculation, or postoperative. Acute pyogenic hematogenous osteomyelitis is the most frequent type in children. This study consisted of 119 cases of acute pyogenic osteomyelitis which were studied at the department of orthopedic surgery, Yonsei university, Severance hospital and Youngdong hospital for 10 years from Jan. 1974 to Dec. 1983. The result were as follows. 1. There were tendency to decrease the frequency of this disease graduaUy since 1973 except 1978. 2. 20 patient (16.8%) had the history of trauma and 43 patients (36.1%) had the entry site of infecting organism. 3. The most frequent involved sites were femur and tibia. 4. E.S.R. was definitely increased in 90.4% of male, in 100% of female. 5. 59.6% of patients revealed the definite bone change at admission on X-ray findings. 6. Staphylococcus coagulase positive was the most frequent organism isolated (95%). 7. The most sensitive antibiotics was cephalosporin and the most resistant was penicillin (90.2%). 8. The antibiotics treatment with immobilization of involved site was initially tried, if there was no symptomatic improvement, the various surgical process was performed with satisfactory result.
Anti-Bacterial Agents ; Child ; Clinical Study ; Coagulase ; Female ; Femur ; Humans ; Immobilization ; Infant ; Male ; Orthopedics ; Osteomyelitis ; Penicillins ; Staphylococcus ; Tibia

Calcaneal fractures involving subtalar joint can be associated with prolonged and severe disability. Many different methods have been tried for the treatment in order to search for better results. From March 1983 to December 1985, 8 cases of calcaneal fractures involving subtalar joint were treated by open rcduction and internal fixation. and the results were as follows: 1. Satisfactory results were obtained from 7 cases out of 8. 2. Anatomic reduction was obtained by open reduction and internal fixation. 3. When medial approach failed, combined lateral and medial approaches gave better visualization of articular fecets and ensured anatomic reduction.
Subtalar Joint

Ossifying fibroma is one of a group of fibro-osseous lesion which arises typically within the jaw bone and only rarely affects the long bones. In 1966, Kempson described two patients with ossifying fibroma of the tibia, noting its unique, aggressive local behavior. This rare lesion resembles monostotic fibrous dysplasia, but can be differentiated from it on histologic and clinical ground. Histologically, ossifying fibroma is characterized by osteoblasstic rimming spicules of bone within a fibrous stroma with evidence of the lamella transformation of bone, and clinically by, frequent recurrence and aggressive progression of the lesion. We experieced three cases of ossifying fibroma, two cases in the tibia and one case in the fibula. In case 1, recurrence was developed after local curettage and bone graft, so reoperation was performed at 11 months after the first opecation. The 2nd case was healed after wide curettage and free vascularized fibula graft, and the 3rd case being followed up after segmental resection of the fibula.
Curettage ; Fibroma ; Fibroma, Ossifying ; Fibrous Dysplasia, Monostotic ; Fibula ; Humans ; Jaw ; Recurrence ; Reoperation ; Tibia ; Transplants

Treatment modalities for herniated lumbar intervertebral disc are the conservative method, chemonucleolysis, percutaneous diskectomy and operation. Conservative treatment is effective in 70–80% of the acute stage and the other 20% requires chemonucleolysis, percutaneous diskectomy or operation. Indications for operation are cases not improved after conservative treatment, recurrent cases and cauda equina syndrome. Mixter and Barr(1934) demonstrated that laminectomy and surgical removal of disc material could relieve symptoms, but spinal segmental instability, incomplete removal of the disc and postoperative adhesion of the nerve root caused low back pain after long-term follow up. Thus, the authors evaluated the plain X-ray and computed tomographic findings in 21 cases of failed laminectomy to determine the cause of failure. The results were as follows ; 1. Among 21 cases, 18 cases complained of low back pain with sciatica and 3 cases complained of low back pain. 2. In all cases, disc space narrowing was detected on plain X-ray. Total laminectomy and diskectomy promote insufficiency and instability of the lumbar and lumbosacral spine. Whenever one attempts to do total laminectomy and diskectomy, it is recommended that spine fusion be performed in same operating field. 3. Several findings were detected on CT scan : 8 disc protrusions in the operation site, 6 disc protrusions in the operation site and spinal stenosis, 4 extradural scars, 1 extradural scar and other site disc protrusion and 2 cases of spinal stenosis and spondyloisthesis. 4. Computed tomography in cases of failed laminectomy offers more information than has been available by any other imaging method.
Cicatrix ; Diskectomy ; Diskectomy, Percutaneous ; Follow-Up Studies ; Intervertebral Disc ; Intervertebral Disc Chemolysis ; Laminectomy ; Low Back Pain ; Methods ; Polyradiculopathy ; Sciatica ; Spinal Stenosis ; Spine ; Tomography, X-Ray Computed

Measurements of mitral flow velocity by pulsed Doppler echocardiography are very useful in evaluating left ventricular diastolic filling properties. In hypertensive patients, abnormalities of diastolic function may precede systolic abnormalities and may serve as a more sensitive marker of end organ damage. We estimated left ventricular nass by 2-D echo short axis area-length method and compared with peak mitral flow velocity in early diastole(PFVE)and during atrial systolic(PFVA). There was a significant increase of LV mass and LV mass indices in the hypertensive patients and PFVE/PFVA ratio was decreased in them. Aithough there was no relationship between blood pressure and PFVE/PFVA ratio, a significant relationship was demonstrated between LV mass index and PFVE/PFVA ratio in the hypertensive patients.
Axis, Cervical Vertebra ; Blood Pressure ; Echocardiography, Doppler, Pulsed ; Humans

PURPOSE: The purpose of this study was to examine the experiences of the use of external breast prostheses among breast cancer survivors in Korea. METHODS: A qualitative descriptive study was conducted, using focus groups. Data were collected from breast cancer survivors who were patients of C women's hospital in Seoul, Korea. Data were analyzed using content analysis in order to identify significant themes. RESULTS: Participants included forty breast cancer survivors who had mastectomy as a surgical treatment. Four themes emerged from the collected data were: 1) concern over the high price of external breast prosthesis, 2) irregular use of external breast prosthesis, 3) unsatisfied with mastectomy bra, and 4) wanting to hide or not to talk about using breast prosthesis openly. CONCLUSION: Since most participants reported irregular use and negative experiences related to external breast prosthesis or mastectomy bra use, healthcare workers should allow more time for proper fitting and counseling and consulting with breast cancer survivors. In addition, health care providers as well as family and friends should keep in mind that cancer survivors need support that can help them cope by using positive reframing. Furthermore, improvements in the coverage of costs and services are needed for these women. This would be helpful for breast prosthesis users.
Breast ; Breast Neoplasms ; Counseling ; Delivery of Health Care ; Female ; Focus Groups ; Friends ; Health Personnel ; Humans ; Korea ; Mastectomy ; Phosphatidylethanolamines ; Prostheses and Implants ; Survivors

No abstract available.
Tissue Expansion Devices*

Generalized granuloma annulare is manifested by numerous, symrnetrical, shiny, normal-skin colored, discrete or confluent, papular eruption on the sunexposed areas, mostly in females of past middle age. Up to date, a variety of therapeutic approaches have been tried with inconsistent results. Recently several agents have been reported to be inconsistent results. Recently several agents have reported to be effective in the treatment of genealizecl granuloma annulare. Of these, dapsone has been used with favorable respones. The fact dapsone can inhibit the lysosomal enzyme release and the mononuclear cell-rnediated rnyeloperoxidase cytotaxicity would account for its effect in granuloma annulare even in part. We observed a case of generalized granulare in a 49-year old man, who had had numerous normal-skin colored or faintly violaceous, flattopped papular eruption on the sun-exposed areas for 3 years. He was treated successfully with dapsone 100mg a day for about 22 months.
Dapsone* ; Female ; Granuloma Annulare ; Humans ; Middle Aged

This report presents a case of metasric calcinosis cutis resembling pseudoxanthoma elasticum in clinical appearance. The patient, 19-year-old man, has dull yellowish firm folded lesion on both axillae, and immobility of lower extremities because of bony osteoporosis, knee fracture, impaired renal function, Skin biopsy, bone marrow biopsy, bone X-ray, and laboratory findings showed metastatic calcinosis cutis due to histiocytosis X and chronic renal failure.
Axilla ; Biopsy ; Bone Marrow ; Calcinosis* ; Histiocytosis, Langerhans-Cell ; Humans ; Kidney Failure, Chronic ; Knee ; Lower Extremity ; Osteoporosis ; Pseudoxanthoma Elasticum* ; Skin ; Young Adult