This relatively uncommon malignant melanoma (incidence less than 5/100, 000 population) is attested to by the fact that despite accounting for only 3% of all cutaneous malignant neoplasms and causes 67% of the deaths attributabIe to skin cancer. Sunlight pIays a major role in. the development of melanoma. Several factors influence the clinical course of malignant melanoma, such as sex, site, type of ma1ignant melanoma, degree of cellular anaplasia, inflammatory reaction and thickness of the lesion. Two caees of malignant melanoma were presented. The one was 55 year old male who had been suffered from large pea sued blackish ulcerative lesion on the lft sole aince 3 years before. The other one was 66 year old female wha had been suffered frorn walnut sized ulcerative lesion on the right inner wrist joint with regional lymph adenopathy since 2 yea,ra before. The patient was treated with wide surgical excision, regionaI lymphnode dissection and subcutaneous injection with Tubercin-3. The first male patient was treated completely but second female patient shows recurrence of the lesion on the right forearm and upper arm within 40 days.
Aged ; Anaplasia ; Arm ; Female ; Forearm ; Humans ; Injections, Subcutaneous ; Juglans ; Male ; Melanoma* ; Middle Aged ; Peas ; Recurrence ; Skin Neoplasms ; Sunlight ; Ulcer ; Wrist Joint

The maximal stress exercise test was studied in 49 normal korean and 231 cases of various diseases. Bicycle ergometer was used in 122 cases and treadmill was used in 109 cases by modified Bruce protocol which was designed by author. The maximal heart rate, maximal work capacity, End point of maximal exercise and ST changes especially in coronary artery disease were investigated. Total 231 cases in cluded 8 cases of myocardial infarction, 46 cases of anginal pectoris, 91 cases of atypical anginal pain, 68 cases of hypertension and 18 and of diabetes mellitus. The results are as follows; 1. The maximal heart rate was markedly reduced in myocardial infarction(115/min. comparing 162/min. in normal) and slightly less reduction in angina pectoris. Also mild reductions were observed in atypical anginal pain, hypertension and diabetes mellitus. 2. The maximal work capacity was markedly reduced in myocardial infarction(93 wt comparing 180 wt in normal). It was only slightly reduced in anginal pectoris, atypical anginal pain, hypertension and diabetes mellitus which were not significantly reduced from that of normal, especially in anginal pectoris, the reduction on maximal work capacity was unremarkale comparing that of maximal heart rate. 3. The End point of maximal exercise test were exhaution in 34%, leg pain in 30%, maximal heart rate in 22%, ST depression more than 1 mm in 21%, dyspnea in 19%, anginal pain in 15% by bicycle ergometer, while by treadmill test, the End point were exhaution in 47%, dyspnea in 35%, Maximal heart rate in 22%, ST depression more than 1 mm in 19%, leg pain in 15% and anginal pain in 10%. 4. In coronary artery disease, the positive maximal exercise test(sensitivity) was 76% in treadmill test and 68% in bicycle ergometer test. 5. The ST changes among 231 patients druing the maximal exercise test occured in 47 cases(20%). In 43 cases the ST segment depressed more than 1 mm and the degree of depression ranged 1-3.5mm. The upward sloping type and horizontal depression type were equally common. There were 4 cases(1.7%) of ST elevation during exercise which returned to normal after exercise. There were 3 cases among 54 cases of coronary artery disease(5.5%) and 2 cases among 46 cases of anginal pectoris(4.3%). In one case of anginal pectoris with elevated ST segment, myocardial infarction occured in few days later. Therefore it appears that the variant angina in this study is very few.
Angina Pectoris ; Coronary Artery Disease ; Coronary Vessels ; Depression ; Diabetes Mellitus ; Dyspnea ; Exercise Test* ; Heart Rate ; Humans ; Hypertension ; Leg ; Myocardial Infarction

Fracture of the metal base of tihial components of total knee arthroplasty has heen occasionally reportecl. The most common cause of the failure of the metal hase plate was known to be a fatigue fracture around the screw hole where the strength of the metal hase plate was the weakest. We experienced a case of the fracture of the metal hase plate secondary to the t'racture of the posteromedial corner of the metal tihial condyle which was weakened due to the shoil peg hole for the base plate of MG II implant. Since the proximal portion of the posterior tihial condyle was normally thin, cutting the hone for the base plate made it thinner and wcaker than normal. Therefore stress fracture of the bone occurred and the overlying metal plate was subsequently hroken. From this experience. we concluded that the posterior peg hole may cause unwanted failure of the posteromedial corner of the tibial base plate.
Arthroplasty* ; Fractures, Stress ; Knee*

Previously severe multiple injuries associating the segmental fractures of the femurs were reported to be rare, and as a rule were fatal when surgeons did not immediately give or provide excellent care. Recently many patients having those injuries are quite often encountered at the clinic. The reason is high incidence of the mass casualties by road accidents, mine accidents and accidents at the industrial complexes. Also as the other reason, the advanced resuscitative measures which could do many of these patients to survive can be listed. For those severely injured patients associating segmental fracture of the femur, the more positive and efficient diagnostic and therapeutic measures have to be sought. Authors analyzed the 18 cases of segmental fractures of the femurs who were treated at the Orthopedic department of Catholic Medical College & Center from Jan., 1974 to Dec., 1979. The results obtained were as follows: 1. The male patients outnumbered the female in ratio of 13/5, and the most were at their 4th and 5th decade of age. 2. Traffic accident was the main cause of the injury; 13 out of 18 cases. Remaining 5 cases sustained injury by industrial accident. 3. All but one were closed fracture, and segmental shaft fracture was the commonest type of them; 10 out of 18 cases. 4. Thirteen patients accompanied significant injuries to other vital organ and/or other musculoskeletal system. 5. In entire cases the average union time in the proximal fracture was 28.9 weeks, and in the distal one 17.5 weeks. 6. Fractures regardless of their group that needed late bone grafting procedure numbered 7; 6 in the proximal shaft fracture and one in the distal fracture. 7. In 10 cases of the segmental shaft fracture (Group III fracture), bony union in the proximal fracture was obtained at 29.6 weeks in average. Proximal fractures in 4 cases in this group needed late bone grafting. Through these results it is suggested that in the treatment of segmental fracture of the femur, primary bone grafting at the proximal fracture site is beneficial to promote fracture healing or to prevent delayed union or nonunion especially when the proximal fracture is located across mainly the cortical part of the bone. Methods of treatment necessarily have to be selected according to the site and shape of the fracture, and in cases of segmental shaft fracture Kuntscher nailing is preferably recommended although the distal fracture site is not ideal one for the Kiintscher nail fixation.
Accidents, Occupational ; Accidents, Traffic ; Bone Transplantation ; Female ; Femur ; Fracture Healing ; Fractures, Closed ; Humans ; Incidence ; Male ; Mass Casualty Incidents ; Multiple Trauma ; Musculoskeletal System ; Orthopedics ; Surgeons

No abstract available.
Arthritis* ; Knee*

Since Thomas et al reported the first instance of successful removal of a broken intravascular guidewire without surgical intervention by using a bronchoscopic forceps in 1964, there have been a number of nonsurgical removal of intravascular or intracardiac foreign bodies using the bronchoscopic forceps, loop snare or basket stone catchers. We experienced a successful retrieval of accidentally broken subclavian puncture catheter from right atrium in 76 year old male patient with cerebral infarction admitted to this hospital on May, 1989. By percutaneous catheterization via right basilic vein, using a loop snare which is modified manually by guidewire for PTCA(USIC(R) Teflon coated PTCA Guide wire : ".014"), we removed successfully foreign body from right atrium. Therefore, we report a case of nonsurgical retrieval of foreign body from right atrium with the review of the literature.
Aged ; Catheterization ; Catheters ; Cerebral Infarction ; Foreign Bodies* ; Heart Atria ; Humans ; Male ; Ocimum basilicum ; Polytetrafluoroethylene ; Punctures ; SNARE Proteins ; Surgical Instruments ; Veins

No abstract available.
Humans ; Hyperthyroidism* ; Procollagen*

OBJECTIVES: This study was designed to investigate the prevalence of depressive symptoms in patients with breast cancer and to identify demographic variables and clinical characteristics impact on depressive symptoms and health related quality of life in patients with breast cancer in a university hospital. METHODS: Fourty-one patients with breast cancer were selected, who had visited the department of General surgery of the Wonkwang University hospital with a diagnosis of breast cancer regularly during the period November, 2010-May, 2011. All of subjects were evaluated for the depression, anxiety and the health related quality of life with Beck Depression Inventory(BDI), anxiety subscale of Personality Assessment Inventory(PAI) and Short-Form 36 Health Survey-Korean version(SF-36-K). Patients were divided into depressive symptoms and non-depressive symptoms group according to the BDI score. We compared SF-36-K between two groups, and analized multiple regression with depression and health related quality of life as criterion variables and demographic and clinical characteristics. RESULTS: The prevalence of depression in patients with breast cancer in a University hospital was 36.4%. Compared to the non-depression, depressed patients with breast cancer appeared significantly lower mean scores on six subscales in SF-36-K : Physical function(p<.01), Role-physical(p<.001), General health(p<.05), Social function(p<.001), Role-emotional(p<.001) and Mental health(p<.001). But there was no significant difference between two groups in Vitality and Bodily pain. Anxiety, level of education and presence of enforcement of chemotherapy(63.6%) were significant explanation variables for depressive symptoms. And type of surgery and age (55.8%) were significant explanation variables for health related quality of life. CONCLUSIONS: The prevalence of depressive symptoms in patients with breast cancer in a University hospital was 36%. The depressive symptoms had not only negative impact on the health related quality of life but also important explanation variable for health related quality of life. These results suggest that depressive symptoms in patients with breast cancer should be evaluated and treated for improving patient's health related quality of life.
Anxiety ; Breast ; Breast Neoplasms ; Depression ; Humans ; Personality Assessment ; Prevalence ; Quality of Life

No abstract available.
Lymphatic Diseases*

No abstract available.
China* ; Depression* ; Republic of Korea*