Polydactyly is the most common congenital anomaly of the upper limb. Polydactyly is classified as preaxial polydactyly(thumb), central polydactyly(index, middle and ring fingers), and postaxial polydactyly(little finger) by the site of the extra digit. A 3-day-old female newborn had a 1.5 * 1.0cm sized flesh color ed pedunculated sac like mass on the proximal phalanx of her right thumb since birth. A roentgenogram on the hand revealed no bony abnormalities of the digit and the mass contained no bony structures. The stalk of the mass was cut by the CO2 laser. On histopathological examination, a cartilage structure was found in the loosely arranged, edematous dermis and the overlying epidermis was flattened. The clinical and histological findings support the diagnosis of preaxial polydactyly. We report this interesting case of preaxial polydactyly with a review of the literature.
Cartilage ; Color ; Dermis ; Diagnosis ; Epidermis ; Female ; Hand ; Humans ; Infant, Newborn ; Lasers, Gas ; Parturition ; Polydactyly* ; Skin* ; Thumb ; Upper Extremity

No abstract available in English.
Arteriovenous Fistula* ; Heart Septal Defects, Ventricular*

No abstract available.
Mitral Valve*

During a 12-month period high-resolution, real-time ultrasonography (US) with graded compression was performed on 268 consecutive patients with clinically suspected acute appendicitis and its complication. US visualization of a fluid-filled, non-compressed appendix or a decompressed, thick-walled appendix was the primary criterion for a diagnosis of acute appendicitis. The sonographic findings were correlated with surgical-pathologic outcome in 92 cases and with the findings of clinical follow-up in the remainder. US was found to be accurate in the diagnosis of acute appendicitis and its complication with a sensitivity of 93.3%, a specificity of 98.9%, and an accuracy of 97%. The predictive value of a positive test was 97.7%; that of a negative test was 96.7%. There were two false-positive examination in patients with a thick-walled appendix or periapperdiceal abscess, which were surgically confirmed as appendiceal adenocarcinoma and perforated cecal diverticulitis respectively. There were six false-negative examination in patients with a sonographically no-visible appendix, which were confirmed surgically as acute appendicitis(n=5) and perforated appendicitis(n=1). Our results show that high-resolution, real-time US is an accureate imaging modality in the diagnosis of acute appendicitis and the evaluation of its complication.
Abscess ; Adenocarcinoma ; Appendicitis* ; Appendix ; Diagnosis* ; Diverticulitis ; Follow-Up Studies ; Humans ; Sensitivity and Specificity ; Ultrasonography*

PURPOSE: We studied the diagnostic significance of bone scan in evaluation of bone metastasis by lung cancer, prevalence rate, and the causes of false positive bone scan and soft tissue accumulation of bone seeking agent. MATERIALS AND METHODS: The subject included 73 lung cancer patients with bone scan. We analyzed the frequency of bone metastasis, its distribution and configuration, and any relationship between bone pain and corresponding region on bone scan. The positive findings of bone scan were compared with simple X-ray film, CT, MRI and other diagnostic modalities. The false positive bone scan and the soft tissue accumulation of bone seeking agent were analized. RESULTS: The positive findings on bone scan were noted in 26 cases(36%) and they were coexistant with bone pain in 30%. The correspondance between bone scan and bone X-ray was 38%. False positive bone scans were seen in 12 cases(16%), which include fracture due to thoracotomy and trauma, degenerative bone diseases, and bifid rib. Accumulation of bone seeking agent in soft tissue were seen in 13 cases(18%), which included primary tumor, enlarged cervical lymph node, pleural effusion, ascites and pleural thickening. CONCLUSION: Bone scans should be carefully interpreted in detecting bone metastasis in primary malignancy, because of the 16% false positivity and 18% soft tissue accumulation rate. It is very important to note that the correlation between bone pain and positive findings of bone scans was only 38%.
Ascites ; Bone Diseases ; Humans ; Lung Neoplasms* ; Lung* ; Lymph Nodes ; Magnetic Resonance Imaging ; Neoplasm Metastasis ; Pleural Effusion ; Prevalence ; Ribs ; Thoracotomy ; X-Ray Film

There are many procedures for treatment of injuries of acromioclavicular separation, but still controversies concerning the best management of these injuries. From March 1981 to August 1984 at Masan Korea Hospital, twelve cases were treated by technique of modified Phemister method, two cases by Dewar and Barrington method, two cases by Stewart method, one case by Neviaser method, three cases by skillful neglect method and two cases by shoulder harness immobilization. The following results were obtained. 1. These injuries were more prevalent in male and more in right side. 2. The most common cause of injuries was traffic accident and followed by falling from the height. 3. Three cases were grade 2 and nineteen cases grade 3 by Allman's classification. 4. We treated these injuries by operative method in seventeen cases and non-operative method in five cases. 5. There were good functional results of treatment in operative method. 6. There were two cases of superficial wound infection, two cases of migration of K-wire and one case of recurrence of deformity in operative method, and two cases of shoulder stiffness and 2 cases of recurrence of deformity in non-operative method.
Accidental Falls ; Accidents, Traffic ; Acromioclavicular Joint ; Classification ; Congenital Abnormalities ; Humans ; Immobilization ; Korea ; Male ; Methods ; Recurrence ; Shoulder ; Wound Infection

Apert described acrocephalosyndactly as a clinical entity in 1906. The classic description of this syndrome includes patient with a combination of acrocephaly and syndactyly of either fingers, toes or both. More than 200 cases have been reported in the world literature. Authors experienced on case of the classic pattern of Apert syndrome and treated surgically for syndactyly. This one case was reported on this paper with brief review of the relevant literatures.
Acrocephalosyndactylia ; Craniosynostoses ; Fingers ; Humans ; Syndactyly ; Toes

Twenty-six cases of fracture of the femur and tibia on the same leg were treated in Masan Koryo General Hospital during the period 1981 1986. We studied all of these patients, divided by four groups according to the method of treatment, retrospectively with analysis of treatment and end results. The results were as follows : 1. Twenty-two patients were male and four patients were female. Of twenty-six patients, eighteen patients were at their third and fourth decades. 2. The main cause of injuries was traffic accident; 23 patients(88%). 3. The most common concomitant injury was fracture and dislocation in other site(14 cases). The fat embolism developed in one case and one patient had died due to head injury. 4. The average healing time of fracture was 17 weeks in femur and 20 weeks in tibia in group three, that was most rapid of all groups. 5. A good or excellent functional result was achieved in 87% of the patients treated with internal fixation of both fracture, 75% of the patients with internal fixstion for the femur fracture and external fixation for the tibial fracture, and 25% of the patients trested conservatively.
Accidents, Traffic ; Clinical Study ; Craniocerebral Trauma ; Dislocations ; Embolism, Fat ; Female ; Femur ; Hospitals, General ; Humans ; Leg ; Male ; Methods ; Retrospective Studies ; Tibia ; Tibial Fractures

To evaluate the high-resolution computed tomography (HRCT) findings of pleuropulmonary involvement in systemic lupus erythematosus (SLE), we analyzed HRCT findings of 12 patients of clinically confirmed SLE with respiratory symptoms. In four patients, HRCT findings before and after chemotherapy were compared. The common HRCT findings were ground-glass opacity (100%), bronchial wall thickening (66%), patchy parenchymal opacity (58%), septal or intralobular line thickening (58%), micronodule (58%), central core prominence (41%), small pleural effusion (91%), and pericardial effusion (33%). Follow-up HRCT obtained after treatment showed significant improvement of pleural effusion(4/4), pericardial effusion (3/3), pericardial thickening (1/1), patchy opacity (2/2), and ground glass opacity (2/4). But bronchial wall thickening (2/2) and micronodule (2/2) were not improved. Although there are no pathognomonic HRCT findings in SLE, bilateral small pleural effusion, ground glass opacity, subpleural patchy opacity, and micronodule are common and suggestive findings in the pleuropulmonary involvement of SLE.
Drug Therapy ; Follow-Up Studies ; Glass ; Humans ; Lupus Erythematosus, Systemic* ; Pericardial Effusion ; Pleural Effusion

BACKGROUND: To decrease the risk of pulmonary aspiration of gastric contents, patients are routinely asked not to eat or drink anything for at least 6 to 8 hours before surgery. We studied to evaluate whether the volume and pH of gastric fluid immediately after induction of anesthesia is correlated with water ingestion. METHODS: Fifty patients, scheduled for elective surgery, were randomly divided into two groups. Control group(n=25) were fasted overnight and received no water. Experimental group(n=25) were fasted overnight and received 150 ml water approximately 2 hours before the induction of anesthesia. Gastric fluid was obtained via multiorifice gastric tube with the patient in three different positions. The volume of gastric fluid was recorded and its pH was measured. RESULTS: The gastric volumes were no differences between the two groups. The gastric pH values were significant differences. The incidence of patients with the high risk factors of gastric volume greater than 25 ml and pH less than 2.5 was decreased in experimental group. CONCLUSIONS: We concluded that surgical patients could be permitted to ingest 150 ml water approximately 2 hours before the induction of anesthesia.
Adult* ; Anesthesia ; Eating* ; Humans ; Hydrogen-Ion Concentration* ; Incidence ; Risk Factors ; Water*