Pyogenic osteomyelitis is at times tragic disease from which severe deformity and disability may result. The incidence and mortality rate of pyogenic osteomyelitis have decreased strikingly since penicillin became available for general use in the treatment of pyogenic osteomyelitis in 1944 and had a dramatic effect. Recently, since the use of new antlblotics, the effect of treatment has been expected in Pyogenic osteomyelitis. But causative organisms of pyogenic osteomyelitis was gradually increasing in resistance to antibiotics. There is also a trend of gradual increase of pyogenic osteomyelltis due to Gram negative bacilli. The author has been analysed 134 patients on whom followup was observed for a minimum of six months at the Department of Orthopedic Surgery of Hanyang University from May, 1972 to December, 1978. The results were as follows: 1. The incidence of pyogenic osteomyelitis is a trend of gradual increase with 14.2% in 1973, 15.7% in 1975 and 26.9% in 1978. 2. Sex ratio was 2.6: 1 (Male: Female): Age distribution showed the group between 5 and 15 years old was 20 patients(62.5%) in acute osteomyeIitis, and the group between 15 and 30 years oId was 52 Patients (51%) In chronic osteomyelitis. 3. The order of involved bones is femur(41%), tibia(27.8%) and humerus(10.4%). 4. Erythrocyte sedimentation rate was remarkably increased in 92.8% of male and 86.5% of female. 5. The causative organism was mostly staphylococcus aureus(84%) in acute osteomyelitis, and Staphylococcus aureus(44.8%), mixed organisms(20.9%) and Gram negative, bacilli(8.3%) in chronic osteomyelitis. Especially, mixed cases with Staphylococcus aureus and Gram negative bacilli contain 55% of mixed organisms. 6. Penicillin was most resistant (79.7%) to Staphylococcus aureus. Cloxacillin was most susceptable (91.3%) to Staphylococcus aureus. 7. The treatment of acute osteomyelitis showed arrest(72.7%) in case of massive antibiotics by early finding of clinical symptom, but if clinical symptoms were not improved within 48 hours with the use of antibiotics, early decompression was done and was arrested(84.6%) in acute osteomyelitis. Closed continuous irrigatlon with saucerization was done and was arrested(85.7%) in chronic osteomyelitis.
Age Distribution ; Anti-Bacterial Agents ; Blood Sedimentation ; Clinical Study ; Cloxacillin ; Congenital Abnormalities ; Decompression ; Female ; Follow-Up Studies ; Humans ; Incidence ; Male ; Mortality ; Orthopedics ; Osteomyelitis ; Penicillins ; Sex Ratio ; Staphylococcus ; Staphylococcus aureus

By Enzinger and Weiss classification, 664 cases of soft tissue tumors, which were confirmed histologically at the department of pathology of Hangang Sacred Heart Hospital from Janusry 1979 to December 1988, were analyzed statistically. The results were as follows : 1. Of the 664 cases, 261 cases (39.3%) were consulted at the Department of General Surgery, 124 cases (18.7%) were consulted at the Department of Orthopedic Surgery, 115 cases (17.3%)were consulted at the Department of Dermatology. 2, Of the 664 cases, 631 cases (95%) were benign and 33 cases (5%) were malignant. 3. The most common benign tumor was lipoma, which was followed by hemangioma and lymphangioma. Among malignant tumors liposarcoma was the most common one, followed by malignant fibrous histiocytoma. 4. The distribution of age of benign tumor was relatively even from childhood to old age but that of malignant tumor showed highest prevalence in 7th decade. 5. The distribution of sex of benign tumor showed male to female ratio of 1: 1.1 but that of malignant tumor showed male to female ratio of 1.5: l. 6. The predilection sites of benign tumors were head, neck and trunk, but those of malignant tumors were lower extremities and trunk. 7. Kinds of soft tissue tumors consulted at the Department of Dermatology were hemangioma, neurofibroma, lipoma, dermatofibroma, ymphangioma, leiomyoma, juvenile xanthogranuloma, xanthoma, keloid and neurilemmoma.
Classification ; Dermatology ; Female ; Head ; Heart ; Hemangioma ; Histiocytoma, Benign Fibrous ; Histiocytoma, Malignant Fibrous ; Humans ; Keloid ; Leiomyoma ; Lipoma ; Liposarcoma ; Lower Extremity ; Lymphangioma ; Male ; Neck ; Neurilemmoma ; Neurofibroma ; Orthopedics ; Pathology ; Prevalence ; Xanthogranuloma, Juvenile ; Xanthomatosis

Technology for the long-term preservation of gamete and embryo has improved greatly over the past 20 years and currently is used for supporting various assisted reproductive technologies (ART). Recent progress in cryobiology and its related sciences have made it possible to preserve human embryos effectively, and several cryopreservation methods also have been developed. Successful freezing of supernumerary embryos has allowed patients undergoing ART the opportunity to achieve pregnancies from more than one embryo transfer without being subjected to controlled ovarian hyperstimulation and oocyte retrieval each time. It also allows a delay in embryo transfer where certain adverse conditions exist for fresh transfer, e.g. when the patient is at risk for ovarian hyperstimulation syndrome or when there is poor endometrial development during the retrieval cycle. Cryopreservation of all available embryos from retrieval is utilized when an oocyte recipient is not properly synchronized with oocyte donor's cycle. In this paper is to review the current status and perspectives of embryo cryopreservation in ART program. Also, briefly discuss the oocyte cryopreservation for the establishment of ovum bank.
Cryopreservation* ; Embryo Transfer ; Embryonic Structures* ; Female ; Freezing ; Humans* ; Oocyte Retrieval ; Oocytes ; Ovarian Hyperstimulation Syndrome ; Ovum ; Pregnancy ; Reproductive Techniques, Assisted

PURPOSE: There are a few reports in the literature that deal with the results of total knee replacement arthroplasty in young rheumatoid arthritis patients. This study was undertaken to evaluate the results of total knee replacement arthroplasty in rheumatoid arthritis patients under the age of 45 years. MATERIALS AND METHOD: Between 1989 and 1993, 43 total knee replacement arthroplasties were performed in 26 adults with rheumatoid arthritis. The age at operation ranged from 23 to 45 years old (average 36.3 years). Of these, four patients (six knees) were lost to follow-up, so 37 knees in 22 patients were available for the follow-up evaluation at a mean 7.8 years (5-8.9). RESULTS: Preoperative flexion contracture was found in 33 knees (89.2%) among 37 knees and it was corrected by operation from 33.1 to 2.6 postoperatively. So the range of motion also improved by an average of 25.6 compare with preoperative state. At the time of final follow-up, six patients were free of pain and 15 patients had mild pain during weight-bearing state, but one patient, with loosening evidence complained of occasional moderate pain. The American Knee Society knee score was improved from a mean of 37.9 points preoperatively to 84.9 points postoperatively. There were 22 excellent, 14 good and one poor (loosening case) results. All patients were able to walk after the operation from 11 non-ambulators and 11 ambulators, assisted with a walking device in preoperative state. The average functional score also improved from 11.9 points to 86.8 points. Radiographic evaluation revealed a radiolucency rate of 43.2%, and revealed radiolucent line adjacent to 3 femoral and 15 tibial components. Almost all of the patients (91%) were satisfied with the result of operation, subjectively. Only one patient had a revision because of subsidency and loosening of a tibial prosthesis. CONCLUSIONS: We considered that total knee replacement arthroplasty for patients with rheumatoid arthritis and was less than 45 years old provided satisfactory and effective results.
Adult ; Arthritis, Rheumatoid* ; Arthroplasty* ; Arthroplasty, Replacement, Knee* ; Contracture ; Follow-Up Studies ; Humans ; Knee ; Lost to Follow-Up ; Middle Aged ; Prostheses and Implants ; Range of Motion, Articular ; Walking ; Weight-Bearing

The ankle is a complex, weight bearing joint consisting of tibia, fibula, talus, and many soft tissue structures, which play an important role biomechanically. The injuries to the ankle joint include not only fractures of bone but significant injuries of ligaments and other soft tissues. It is very important to understand the mechanisms of trauma in order to make definite diagnosis and proper treatment. The author' analysed 127 eases(126 patients) of the ankle fractures which were admitted and treated in Orthopaedic Department,Hanyang University Hospital from January 1978 to December 1985. The results obtained from this study were as follows: 1. Of the 127 cases, male was 90 cases(70.87%), female was 37 cases(29.13%), and average age of the patients was 37.6 years. 2. Open fractures were 12 cases(9.4%) and closed fractures were 115 cases(90.6%). 3. According to the classification of Lauge-Hansen, the most common type of the ankle fracture was supination-external rotation type (35.43%). 4. Of the 127 cases, 63 cases were treated by closed reduction and 64 cases by open reduction. 5. The average period of the cast immobilization after open reduction was 7.8 weeks, where as that of closed reduction was 10.5 weeks. 6. According to clinical and radiological assessment of the result of the treatment, open reduction was better than closed reduction. 7. The best result of the treatment was noticed in supination-adduction type, according to the classification of Lauge-Hansen. 8. Accurate reduction and rigid internal fixation of the fractured lateral malleolus and distal fibuIa was important in treatment of the ankle fracture.
Ankle Fractures ; Ankle Joint ; Ankle ; Classification ; Clinical Study ; Diagnosis ; Female ; Fibula ; Fractures, Closed ; Fractures, Open ; Humans ; Immobilization ; Joints ; Ligaments ; Male ; Talus ; Tibia ; Weight-Bearing

Brachiocephalic venous aneurysm (BVA) development is an extremely rare, particularly as a primary vascular disorder. BVAs may be misinterpreted as lymphadenopathies owing to the variable degrees of enhancement seen in imaging studies, especially among patients with underlying malignancy. We report a BVA that mimicked lymph node metastasis on CT in a 60-year-old female who had undergone subtotal gastrectomy for stomach cancer. After followup chest CT with different bolus times and Doppler ultrasonography, a venous aneurysm originating from the brachiocephalic vein was diagnosed. We emphasize that, to make an accurate diagnosis, physicians should be aware of the potential diagnostic pitfalls and have a high index of suspicion for BVA when encountering certain lesions in the cervical area.

Peripheral neuropathies occur in lymphoma patients. Causes of neuropathy include chemotherapy, opportunistic infections, and the lymphoma itself. We report a patient with lymphoma whose chief complaint was a sensory loss in the hands and feet. Electrophysiologic studies and sural nerve biopsy showed sensory polyneuropathies. We hypothesize that this neuropathy is associated with lymphoma-related ganglionopathy, and among the possible causes, we suspect that a systemic cause such as a paraneoplastic syndrome is the most likely pathogenic etiology. However, further follow-up will be necessary to see whether sensory symptoms change with lymphoma treatment.
Adult ; Biopsy ; Electrophysiology ; Hodgkin Disease/*complications/*diagnosis ; Human ; Lymphatic Metastasis ; Lymphoma/*metabolism ; Male ; Peripheral Nervous System Diseases/*complications/*pathology ; Sensation Disorders/complications/pathology

No abstract available.
Hemorrhoidectomy* ; Hemorrhoids* ; Ligation* ; Rubber*

A thirty nine year-old male patient was scheduled for emergent craniotomy and epidural hematoma evacuation under general anesthesia. All data of the preoperative check lists for emergent operation were within normal limits and vital signs of the patient were stable. During the induction of anesthesia an armored tube was inserted into the trachea for this operation. Approximately 110 minutes after the induction of anesthesia, signs of complete airway obstruction developed abruptly. At that time we deflated the cuff balloon to exchange the tube. Then, the signs of airway obstruction disappeared completely. Therefore the deflation of cuff balloon is recommended in order to exclude the obstruction by the displaced cuff.
Airway Obstruction* ; Anesthesia ; Anesthesia, General ; Craniotomy ; Hematoma ; Humans ; Intubation ; Male ; Trachea ; Vital Signs

Lesions of multiple sclerosis (MS) are rarely distributed in deep gray matter. We report a case of MS with hypothala-mic lesions. A 26-year-old woman with MS developed hyperphagia, hypersomnolence, and amenorrhea. Brain MRI revealed bilateral lesions in both hypothalamus and thalamus. Serum prolactin concentration was increased and thyroid stimulating hormone (TSH) level was decreased. Three months after steroid pulse therapy, her symptoms were com-pletely resolved and prolactin concentration became normal Follow-up brain MRI demonstrated complete disappear-ance of previous lesions.
Adult ; Amenorrhea ; Brain ; Disorders of Excessive Somnolence ; Female ; Follow-Up Studies ; Humans ; Hyperphagia ; Hypothalamus* ; Magnetic Resonance Imaging ; Multiple Sclerosis* ; Prolactin ; Thalamus ; Thyrotropin