A tumor of the neuromyoarterial apparatus, the glomus, was described by Masson : the epitheloid cell of glomus was derived from the pericyte of Ziemmermann and these cells were widely distributed in the body. From Jan. 1987 to Oct. 1993, six patients (male 1, female 5), who were diagnosed as a glomus tumor in the hand were operated. The lesions were distributed in the distal phalanges of thumb (3 cases), index (1 case), ring finger (1 case) and little finger (1 case). The average duration of clinical manifestation was 6.3 year. Nail extraction was performed because of pain in 2 cases, but symptom was not improved. The clinial symptoms were severe lancinating pain, tenderness and cold induced pain in all 6 cases, palpable mass in 2 cases, bluish purple discoloration of skin in 4 cases, subcutaneous hemorrhage in 1 case, swelling in 2 case. On the reontgenography, bone changes were detected in 2 cases, soft tissue change was detected in 1 case and 3 cases showed unremarkable findings. The treatments were simple excision in 5 cases,curettage and bone graft in 1 case and symptoms were improved in the 6 case with the remnant mild pain and there was no recurrence. The aim of this study was to report the rare cases of glomus tumor in the hand.
Female ; Fingers ; Glomus Tumor ; Hand ; Hemorrhage ; Humans ; Pericytes ; Recurrence ; Skin ; Thumb ; Transplants

No abstract available.
Humans ; Infant, Newborn*

Fifteen shoulders in 15 patients with traumatic recurrent anterior dislocation were performed from Sept. 1993 to April 1994. The position in which the dislocation occurred were abduction and external rotation in 10 cases, but most likely direct injuries in the 13 cases. The average interval between the initial and second dislocation was 5.4 months, and the average frequency of dislocation was 15 times per year. Physically, crank test in 13, fulcrum test in 12, sulcus test in 4, and jerk test in 3 cases were positive. The classic Bankart lesions were 4 cases, the bony Bankart lesions in 11 cases, so all of them had an abnormal tension on the inferior glenohumeral ligament. The Hill-Sachs lesions were associated in 14 cases, the Superior Labrum Anterior Posterior lesion in 1 case. Traditional Bankart procedure in 12 cases, traditional method and shift surgery simultaneously for inferior laxity in 3 cases were performed. In 4 cases of bony Bankart lesion with large bone fragment, anterior capsule and subscapularis muslce was splitted during exposure. Velpeau sling was applied in a daytime for postoperative immobilization, exercise with 90° of flexion but no external rotation was permitted during 3 weeks after operation. After than 140° of flexion and 40° of flexion and averag 57° of external rotation. There was no recurrence in our series. The result at follow up were exellent in 9 cases, good in 6 cases.
Dislocations ; Follow-Up Studies ; Humans ; Immobilization ; Ligaments ; Methods ; Recurrence ; Shoulder

Pedicled bone flap raised from the volar aspect of lower end of the radius, pedicled by the pronator quadratus has been used for the treatment of scaphoid nonunion and Kienbock's disease. From July 1991 to Jan. 1992, authors performed this procedures for 3 cases of Kienbock's disease. Patients were 2 cases in the left hand, l case in the right hand. There was no critial trauma history. Age at operation were 25, 37 and 57 years. All patients were in Stage I in 2 cases and stage II-A in 1 case of Lichtman's radiologic classification. Preoperative grip powers were 11%, 38%, 63% and pinch powers were 20%, 41%, 61% of that of normal opposite hand. Follow up periods were 28, 31 and 33 months. At last follow up roentgenographic finding shows no progression of necrosis of lunate, new bone formation, decreased sclerosis, and joint space were preserved in all cases. The fuctional results at the last follow up were as follows. Pain during motion was markedly diminished in all patients. Grip power were 57%, 89% and 96% and pinch powers were 68%, 83% and 100% of that of normal opposite hand with use of calibrated Jamar dynamometer which showes significant increase than preoperative state. The ranges of motion of wrist were as follows. Volar flexion were 40, 45 and 80 degree. Dorsiflexion were 10, 20 and 45 degree. Ulnar deviation were 10, 20 and 30 degree. Radial deviation were 10, 25 and 30 degree. This viable bone graft with blood supply gives very satisfactory clinical results.
Classification ; Follow-Up Studies ; Hand ; Hand Strength ; Humans ; Joints ; Necrosis ; Osteogenesis ; Osteonecrosis ; Radius ; Sclerosis ; Transplants ; Wrist

Indications for bone lengthening in the hand are less common than for the lower extremity. From 1991 to 1993 authors had performed nine hand bone lengthenings in the eight patients, based on callotasis and chondrodiastasis, Average age at the time of surgery was 18 years old(from 4 to 31 years old). Diagnoses included traumatic amputations in 7 cases and congenital syndactyly of both hand with hypoplastic digits in 2 cases. Sites of lengthening were metacarpal bone in 7 cases, phalangeal bone in 2 cases. Eight of 9 lengthening procedures resulted in complete consolidation of the bone gap after the single stage procedure. In one case secondary bone graft was required for the bone defect. Average consolidation period was 16 weeks(from 10 weeks to 22 weeks). Average gained length was 14.6mm (from 6 to 30mm) and average percent of gained digital bone length was 48%. There were minimal complications including marginal necrosis of skin, numbness and bone tip exposure and were responsed to conservative manage, but stump revision for bone tip exposure was performed in one case. In all cases followed to completion and for 1 to 3 years postoperatively, there was improvement of function with key pinch. The callotasis lengthening is one of the useful method of short hand bone lengthening to improve function of hand and cosmetic demand.
Amputation, Traumatic ; Bone Lengthening ; Diagnosis ; Fingers ; Hand ; Humans ; Hypesthesia ; Lower Extremity ; Methods ; Necrosis ; Osteogenesis, Distraction ; Skin ; Syndactyly ; Transplants

Soft-tissue defects over the plantar forefoot, plantar heel, Achilles tendon and distal parts of lower leg are often troublesome to cover with a simple graft or local flap due to limited mobility of surrounding skin and poor circulation in these area. Soft-tissue reconstruction in these regions should provide tissue components similar to the original lost tissue, supply durability and minimal protective pressure sensation and result in a donor site that is well tolerated. We analysed 14 cases that were treated with the instep flap due to soft-tissue defects over these regions from JuL 1990 to Oct. 1995. All flaps were viable and successful at follow-up. 1. The age ranged from 5 years to 70 years, and 13 cases were male and 1 case was female. 2. The sites of soft-tissue loss were the plantar forefoot (l case), plantar heel (9 cases), Achilles tendon (3 cases), and distal part of lower leg (1 case). 3. The causes of soft-tissue loss were simple soft-tissue injury (l case), crushing injury of the 1st toe (1 case), post-traumatic infection and necrosis (11 cases) and traction sore (1 case). 4. The associated injury were open distal tibio-fibular fractures (2 cases), medial malleolar fracture of the ankle (1 case), Achilles tendon ruptures (4 cases) and 1st metatarsophalangeal disarticulation (1 case), open calcaneus fracture (1 case) and femur shaft fracture (1 case). 5. The size of flap was from 3 1 cm to 5 10 cm (average 4 5 cm). 6. We could not find post-operative necrosis and infection, non-viability and gait disturbance caused by the instep flap surgery except limitation of the ankle joint in 1 case. In conclusion, this study demonstrates that the instep flap should be considered as another valuable technique in the reconstruction of these regions.
Achilles Tendon ; Ankle ; Ankle Joint ; Calcaneus ; Disarticulation ; Female ; Femur ; Follow-Up Studies ; Gait ; Heel ; Humans ; Leg ; Male ; Necrosis ; Rupture ; Sensation ; Skin ; Tissue Donors ; Toes ; Traction ; Transplants

In order to evaluate the hypotensive effect of the lisinopril, a long acting angiotensin converting enzyme inhibitor, 10 to 30mg of lisinopril were administered in 35 hypertensive Korean adults during six weeks after a week observation for washout with stepwise increments of the dose according to the response of the patients blood pressure in every two weeks. The results were ; 1) The supine blood pressures were decreased from 163.7+/-16.6/99.8+/-9.3mmHg to 140.7+/-15.5/87.4+/-9.9mmHg at the end of six weeks' drug therapy(p<0.001). The standing blood pressures were also decreased conferrably and to the some lower levels. 2) In 14 patients to whom the drug was administered longer period(12 to 28 weeks) the blood pressure lowering effects were maintained at the level of that of 6th week. 3) Hematologic examination and blood chemistry revealed no discernible abnormal findings before and after the treatment. 4) In those patients who showed no adequate blood pressure control with other classes of antihypertensive drugs the lisinopril was effective in lowering their blood pressures by adding small doses. 5) During the period of the study a few probably drug-related symptoms developed but not troublesome except dry cough and dry mouth shich forced to stop administering the drug after completion of six weeks' period in one patients. From above results we concluded that lisnopril is effective and safe for the treatment of hypertension in Korean adults.
Adult ; Antihypertensive Agents ; Blood Pressure ; Chemistry ; Cough ; Humans ; Hypertension ; Lisinopril* ; Mouth ; Peptidyl-Dipeptidase A

This study was conducted in July-August, 1984, to define the causes of chronic gastrointestinal symptoms in rural population and to provide data for the management of such patients. A household survey was conducted to identify all the residents of Youngchun and Sungju counties in Kyungpook province who were over 20 years of age, had chronic upper gastrointestinal symptoms for over the last 6 months, never had medical examination for the symptoms, and volunteered to participate in the gastroscopic examination. Gastroscopy was done for 106 males and 108 females. Gastric ulcer was found in 16.8% of all the examinees, duodenal ulcer in 15.4%, gastritis in 14.0%, and gastric cancer in 3.7%. No lesion was found by gastroscopy in 52.3%. Gastric ulcer more common in male(26.4%) than in female(7.4%) (p<0.01) and the same was true for duodenal ulcer(20.8% of male, 10.2% of female). Gastric cancer was found in 7.5% of the male while none of the female had gastric cancer. A higher proportion of the female(68.5%) showed normal finding in the gastroscopy than the male(35.9%) (p<0.01). No significant association was found between the upper gastrointestinal symptoms and the gastroscopic findings. The higher prevalence rate of gastric ulcer than that of duodenal ulcer in this study which is the reverse of the study findings of urban area in Korea and western countries may be related in part with the dietary habit and social environment of the rural population. Although early diagnosis is the most important for the treatment of gastric cancer, many of the people with chronic upper gastrointestinal complaints defer the diagnosis and treatment. It is may be due to lack of the knowledge of disease and the health care attitude of the rural people. A national program for the health education and mass screening for the gastric cancer should be developed.
Delivery of Health Care ; Diagnosis ; Duodenal Ulcer ; Early Diagnosis ; Family Characteristics ; Female ; Food Habits ; Gastritis ; Gastroscopy ; Gyeongsangbuk-do ; Health Education ; Humans ; Korea ; Male ; Mass Screening ; Prevalence ; Rural Population ; Social Environment ; Stomach Neoplasms ; Stomach Ulcer

No abstract available.
Tetracycline* ; Thyroid Gland* ; Thyroid Nodule*

PURPOSE: The purpose of this study is to evaluate the characteristics of hallux valgus with severe hallux valgus angle (HVA) and moderate intermetatarsal angle (IMA) after proximal chevron osteotomy. MATERIALS AND METHODS: Between January 2008 and December 2010, 41 patients (48 feet) were treated with proximal chevron osteotomy and distal soft tissue procedure for symptomatic severe hallux valgus deformity (HVA > or =40degrees). Patients were divided into two groups, group M (IMA <18degrees) and group S (IMA > or =18degrees). Mean age of patients was 55.7 years (34~70 years) in group M and 60.0 years (44~78 years) in group S. Mean duration of follow-up was 20.4 months (12~41 months) in group M and 18.5 months (12~35 months) in group S. Radiographic parameters, including HVA, IMA, sesamoid position, metatarsus adductus angle (MAA), and distal metatarsal articular angle (DMAA), were compared between groups. Clinical results were assessed using American Orthopaedic Foot and Ankle Society (AOFAS) score and visual analogue scale (VAS). Recurrence rate at the last follow-up was compared between group M and group S. RESULTS: Preoperative HVA and grade of sesamoid position did not differ between the groups. However, immediate postoperative HVA and grade of sesamoid position were significantly larger in group M. Preoperative MAA and DMAA were significantly larger in group M. No significant difference in AOFAS score and VAS was observed between the groups at the last follow-up. Ten of the 27 feet (37.0%) in group M and two of the 21 feet (9.5%) in group S showed hallux valgus recurrence at the last follow-up. Group M showed a significantly higher recurrence rate than group S. CONCLUSION: Recurrence rate for severe hallux valgus with moderate IMA is higher than that of severe hallux valgus with severe IMA.
Ankle ; Congenital Abnormalities* ; Follow-Up Studies ; Foot ; Hallux Valgus* ; Humans ; Metatarsal Bones ; Metatarsus ; Osteotomy ; Recurrence