BACKGROUND: The aim of this study was to assess demographics, clinical outcomes, and complications of classic floating elbow in adults. METHODS: Six patients with ipsilateral diaphyseal fractures of the humerus, radius, and ulna were reviewed retrospectively. All patients were treated operatively and available for follow-up at a minimum of 1 year after surgery. The average age of the patients was 45.2 years (22-64 years) and the average follow-up period was 37.0 months (14-103 months). They were evaluated with postoperative outcome measures, including a visual analog scale (VAS) for pain, Mayo elbow performance score (MEPS), and American Shoulder and Elbow Surgeons (ASES) shoulder score. Residual complications were also evaluated. RESULTS: Five patients (83.3%) had open fracture, and 4 patients (66.7%) presented with associated nerve injury. All fractures were united within postoperative 4 months, except 1 delayed union. The average VAS pain score, MEPS, and ASES shoulder score at the final follow-up examination was 2.5, 79.8, and 67.5 respectively. Three patients including 2 cases of joint stiffness with incomplete recovery from nerve injury and 1 case of complex regional pain syndrome had poor clinical outcome. CONCLUSIONS: Although the classic floating elbow is rare, these injuries potentially have associated problems such as open fracture or nerve injury. The presence of residual neurological symptoms predispose to poorer clinical outcomes.
Adult* ; Demography ; Elbow* ; Follow-Up Studies ; Fractures, Open ; Humans ; Humerus ; Joints ; Outcome Assessment (Health Care) ; Radius ; Retrospective Studies ; Shoulder ; Ulna ; Visual Analog Scale

"Mammary dysplasia" and "fibroadenoma" represent almost all benign breast disease presenting with breast lumps. Mammary dysplasia comprises variable non-specific changes of stroma and epithelium, but fibroadenoma has been classified as a benign neoplasm, although both features not uncommonly coexist. Authors performed a blind microscopic review of 660 cases of benign breast lesions and the results are as followings. 1. Only 27.9% of all cases consisted of pure fibroadenoma in contrast to 57.5% in the original diagnosis. 2. Fibrocystic disease frequently contained foci of fibroadenoma showing varied stages (68.3%), and the younger age group presented more wide areas of fibroadenoma. 3. The most common feature of the fibrocystic disease was fibrosis, followed by cystic change, adenosis and epithelial hyperplasia in order of frequency. 4. Fibroadenoma may be a form of a spectrum produced by hormonal imbalance, and better classified as a nonneoplastic lesion.

Treatments of tibia shaft fracture are closed reduction followed by cast immobilization, external fixation, intramedullary nailing and internal fixation with plate and screws. Among these, intramedullary nailing is commonly used method today. The tibia nailing has high rate of union, but malunion, infection, the joint stiffness and anterior knee pain develops frequently. We reviewed the clinical and radiological result of anterior knee pain retrospectively after tibia nailing. The result were as follows: l. Age distribution of tibia shaft fracture was 17 to 76, and mean age was 40 male patients were 35 and female 13. 2. The open fractures were 17 and the closed fractures were 34. 3. The causes of' tibia shaft fracture were traffic accidents(30cases), fall down injuries(6 cases), slip down injuries(1 1 cases) and other injuries(4 cases) Among the these, 19 cases were cornbined with other fractures or neuri.isurgical injuries. 4. The incision methods were recorded as follows: parapatella tendon incision were 9 cases, patella splitting incision were 25 cases and unrecorded were 17cases. 5. According to the radiological analysis, the average nail plateau distance was 10.3mm and the extent of nail protrusion beyond the anterior cortex was -1.73mm. Among these, protrusion of proximal targeting screws were 8 cases. 6. Insertion of nail through the patella tendon was associated with a hipher incidence of knee pain compared to paratendon site of insertion. The extent of nail protrusion were related to anterior knee pain after tibia intramedullary nailing.
Age Distribution ; Female ; Fracture Fixation, Intramedullary* ; Fractures, Closed ; Fractures, Open ; Humans ; Immobilization ; Incidence ; Joints ; Knee* ; Male ; Patella ; Patellar Ligament ; Retrospective Studies ; Tendons ; Tibia*

A total of 68 primary melanorna cases diagnosed at Seoul National University Hospital for the past 10 years from 1978 to 1987 were included for this clinico pathological study. Among the 31 primary cutaneous melanomss, 19 cases (61.3%) occurred on hands or feet, especially on the plantar surfaces. The average age of patients with acral melanomas was 49.3 years at the tirne of diagnosis and the male to female ratio of 19 cases was 3.8 to 1. The clinical and histopathologic findings showed that most ecral melanomas, if not all, were the acral lentiginous type. A high incidence of metastasis (73.7%) was recognized in acral melanomas.
Diagnosis ; Female ; Foot ; Hand ; Humans ; Incidence ; Male ; Melanoma* ; Neoplasm Metastasis ; Seoul

A histopathological study of erythema nodosum-like lesions in Behcet's disease was performed on 55 patients with incomplete and suspect types of Behcet's disease. Relatively common characteristics in histopathology of erythema nodosum-like lesions could be found in the patients with incomplete type of Behcet's disease. The histopathologic findings of erythema nodosum-like lesions in 21 patients with incomplete type of Behcet's disease were as follows : l. A moderate lymphocytic infiltration was found around the blood vessels and the sweat glands in the dermis. In the subcutaneous tissue, besides lymphohistiocytic infiltration, neutrophils were present in significant number in 9 cases (42.9%) 2. Vasculitis of small vessels was found within the periphery of fat lobules in 7 cases (81.0%), Five cases (23.8%) also showed thrombophlebitis. Seven cases (33.3%) showed histiocytic granuloma formation within the fat lobules. Microabscess formation in the subcutaneous tissue was seen in 5 cases (23.8 %), but it was not certain whether this was the charateristic feature.
Blood Vessels ; Dermis ; Erythema Nodosum* ; Erythema* ; Granuloma ; Humans ; Neutrophil Infiltration ; Subcutaneous Tissue ; Sweat Glands ; Thrombophlebitis ; Vasculitis

No abstract available.
Lupus Erythematosus, Systemic* ; Pregnancy*

PURPOSE: Epstein-Barr virus(EBV) exists in the human population in two genetic forms, usually referred to as type 1 and type 2 which have been defined on the basis of sequence divergence in the EBNA-2 and EBNA-3 family genes. In this study, we were intended to investigate whether the subtypes of EBV in malignant lymphoma in Korea were associated with specific disease entities and geographical distribution. MATERIALS AND METHODS: Biopsy samples obtained from 18 Korean patients with malignant lymphoma including Hodgkin's disease(3 cases), B cell lymphoma(1 case), and NK/T cell lymphoma(14 cases) were analyzed to determine the subtype of EBV infected therein. DNA was extracted from formalin-fixed, paraffin-embeded tissues by ordinary method and specific viral sequences were sought using the polymerase chain reaction(PCR) and Southern blot hybridization assay. Oligonucleotide primers used for examination of EBV strain type were derived from the EBNA-3B and EBNA-3C coding regions. As a control, four cases of reactive hyperplasia were analyzed. RESULTS: The two of four reactive hyperplasia cases were associated with type 1 and the rest of two cases with both types. Among the 18 cases with malignant lymphoma, thirteen cases(72%) had type 1, one(6%) had type 2, and four(22%) had dual infections with both types. In case of NK/T cell lymphoma(14 cases) occupying 78% of 18 biopsy samples, 86%(12 cases) were associated with type 1, 7%(1 case) with type 2, and 7%(1 case) with both types. In case of Hodgkin's disease, all of three cases had both types. B cell lymphoma taking only one case of twenty two cases was determined as type 1. CONCLUSION: These observations indicated that type 1 EBV was predominant in Korean patients with malignant lymphoma, especially NK/T cell lymphoma and showed high frequency of dual viral infections(22%) in Hodgkin's disease as well as in reactive hyperplasia.
Biopsy ; Blotting, Southern ; Clinical Coding ; DNA ; DNA Primers ; Genotype ; Herpesvirus 4, Human ; Hodgkin Disease ; Humans ; Hyperplasia ; Korea* ; Lymphoma* ; Lymphoma, B-Cell

BACKGROUND: Serious pulmonary complications after lung surgery increase morbidity and mortality in perioperative period. Ketamine hydrochloride produces strong analgesic effect in spite of the psychomimetic effects. Intravenous anesthesia with ketamine was performed in lung surgery of patients with decreased pulmonary function and compared with inhalation anesthesia with enflurane. METHODS: Sixty patients, scheduled for elective lung surgery, were randomly assigned to two groups. Patients received either enflurane (Group 1, n=30) or ketamine (Group 2, n=30) as main anesthetic drug. Blood pressure and heart rate were compared in preinduction, postinduction, postintubation, postincision, intraoperative period (30 minutes, 60 minutes) and recovery room between groups, and in each group. Arterial blood gas analysis was compared in preoperative period, intraoperative period and recovery room between groups. Postoperative psychological complications evaluated in group 2. RESULTS: Blood pressure and heart rate were significantly different in postinduction, postintubation and recovery room between groups. PaO2 in group 2 was higher than in group 1 during intraoperative period and recovery room. Postoperative psychological complications occured in 4 patients (13%) in group 2. CONCLUSIONS: Ketamine affords advantage over enflurane anesthesia in terms of PaO2 during intraoperative period and recovery room in lung surgery of patients with decreased pulmonary function.
Anesthesia ; Anesthesia, Inhalation* ; Anesthesia, Intravenous* ; Blood Gas Analysis ; Blood Pressure ; Enflurane* ; Heart Rate ; Humans ; Inhalation* ; Intraoperative Period ; Ketamine* ; Lung* ; Mortality ; Perioperative Period ; Preoperative Period ; Recovery Room

No abstract available.
Leptospira interrogans* ; Leptospira*

Three cases of angiosarcoma of the breast are described. One case in a 66 year old woman was a solid mass and histologically showed poor differentiation leading to a death 14 months after the diagnosis. Another two in 46 and 25 year old females were large vascular masses showing moderate differentiation with endothelial tufting and papillary projections, and abdominal and contralateral mammary, and liver metastasis occurred within postoperative 10 months and 6 months in each case. A radical mastectomy and adjuvant chemotherapy in case 2 were not lifesaving. Although histologic degree of differentiation seems prognosis-related, angiosarcoma is the most malignant tumor of the breast.
Female ; Humans ; Neoplasm Metastasis