Sixty amputees who had traumatic amputations due to industrial accidents were examined on their phantom limb and phantom pain phenomena and the following results were obtained. 1. Fifty-three (93%) of sixty amputees experienced phantom limb and twenty-four (40%) experienced phantom pain. The incidence of phantom pain in the lower limb amputation (59%) is greater than that of upper limb amputation (29%). 2. Amputees with asthenic body status gave higher incidence (56%) of phantom pain than those with muscular body status (20%). None of amputees with obese body status experienced phantom pain. 3. The sensation of strong current and cramping were most predominant sensations in the phantom pain. 4. Twenty-eight (93%) of thirty amputees had experienced painless phantom limb longer than four months. 5. Six (55%) of eleven upper limb amputees with phantom pain experienced pain sensation at the tips of fingers and nine (69%) of thirteen lower limb amputees with phantom pain experienced pain at the great toe. 6. Fifty-three (88%) of sixty amputees experienced telescoping of the lost limb and twenty-three (38%) of sixty amputees experienced jerking movement of the stump. 7. In fifty-four (90%) of sixty amputees, trigger zones triggering pain in the phantom limb were found in the healthy part of the body. 8. Twenty-two (40%) of fifty-five male amputees experienced burning sensation in the phantom limb associated with urination, defecation or ejaculation. 9. Cold temperature was predominant, aggrevating factor of the phantom pain. Fitting prosthesis and alcohol intake were predominant, relieving factor of the phantom pain.
Accidents, Occupational ; Amputation ; Amputation, Traumatic ; Amputees ; Burns ; Cold Temperature ; Defecation ; Ejaculation ; Extremities ; Fingers ; Humans ; Incidence ; Lower Extremity ; Male ; Muscle Cramp ; Phantom Limb ; Prostheses and Implants ; Sensation ; Toes ; Upper Extremity ; Urination

Although conventional barium study has been used for diagnosis of gastrointestinal lymphoma, CT is superior tobarium study in the evaluation of its extent and relationship to the bowel, lymph node enlargement, and distantmetastasis. The authors analyzed CT features of 21 cases of pathologically proven gastrointestinal lymphoma forrecent 5 years. The results were as follows: 1. In a total 21 cases of gastrointestinal lymphomas, 13 cases wereprimary gastrontestinal lymphoma and others were secondary. But there was no difference in CT featurs betweenthem. 2. Male predominates over female(17:4), and type age ranged from 5 to 73 years old, most common
Abdominal Pain ; Barium ; Colon ; Diagnosis ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Lymphoma ; Male ; Mesentery ; Methods ; Omentum

A case has been reported in which stereotaxic percutaneous cordotomy has been performed for the treatment of an intractable pain in the arm. The 60-year-old male was admitted to this hospital because of right arm pain which was persistant, so severe and intractable to various medical treatment for 2 months prior to admission. The pain in association with right Horners' syndrome has been produced by the involvement of carcinoma in the right apex of the lung to the cords of brachial plexus and superior cervical ganglion. Since the patient was so emaciated and distressed with the pain, the percutaneous cordotomy was indicated for him to cure the pain. Under the local anesthesia the patient was maintained in the supine position with his head held lightly on the head holder. And unilateral high cervical cordotomy by the percutaneous stereotaxic method was performed on the left through C-C2 interlaminar space under radiographic and impedance measurements, which relieved the pain completely with no development of significant postoperative complications. It was simple, safe and effective for the patient who has poor general condition because it does not require a general anesthesia or a period of wound healing and the cooperation of the alert patient eliminates the possibility of paralysis and enhances the changes of securing the desired sensory loss.
Anesthesia, General ; Anesthesia, Local ; Arm ; Brachial Plexus ; Cordotomy* ; Electric Impedance ; Head ; Humans ; Lung ; Male ; Middle Aged ; Pain, Intractable ; Paralysis ; Postoperative Complications ; Superior Cervical Ganglion ; Supine Position ; Wound Healing

There are many clinical reports on implant exposure as a complication of hydroxyapatite orbital implantation, but relatively small number of reports have concerned full range of complications that can occur with hydroxyapatite orbital implants. The authors analyzed all the complications associated with the 110 hydroxyapatite orbital implants performed by one surgeon at the department of ophthalmology, Presbyterian Medical Center between January 1993 and June 1998, and discussed the management and progression of them. There were 8 kinds, 40 cases of soft tissue problems, 3 kinds, 20 cases of eyelid problems, and 7 kinds, 27 cases with prosthesis and pegging.Most of them were improved with conservative management and surgical treatments were required in 2 cases with conjunctival wound disruption, 5 cases with implant exposure, 3 cases with overgrowth of subconjunctival granulation tissue, 3 cases with ptosis, 1 case with eyelid laxity, 2 cases with peg extraction, and 4 cases with poor peg position. Surgeons and patients who want to use hydroxyapatite as an orbital implant would be more satisfied with thorough knowledge on many possible complications and their etiology, proper prevention and management.
Durapatite* ; Eyelids ; Granulation Tissue ; Humans ; Ophthalmology ; Orbit* ; Orbital Implants* ; Prostheses and Implants ; Protestantism ; Wounds and Injuries

When performing septoplasty in patients with a high deviation of the nasal septum, effective correction is difficult and postoperative complications such as a saddle nose may result if the bone or cartilage is removed inordinately. Although several surgical techniques have been introduced, some are difficult to apply easily. Furthermore, the deviation may persist despite the application of surgical techniques due to the rebound memory of the remaining cartilage. This study aimed to describe a simple and safe surgical technique for crooked nasal septa with a high deviation. This method using horizontal dorsal septal incision allows easy separation of the highly deviated portion from the upper lateral cartilage. Furthermore, it is less traumatic than other methods, and predictably preserves the keystone area.

PURPOSE: The prediction of breast cancer recurrence is a crucial factor for successful treatment and follow-up planning. The principal objective of this study was to construct a novel prognostic model based on support vector machine (SVM) for the prediction of breast cancer recurrence within 5 years after breast cancer surgery in the Korean population, and to compare the predictive performance of the model with the previously established models. METHODS: Data on 679 patients, who underwent breast cancer surgery between 1994 and 2002, were collected retrospectively from a Korean tertiary teaching hospital. The following variables were selected as independent variables for the prognostic model, by using the established medical knowledge and univariate analysis: histological grade, tumor size, number of metastatic lymph node, estrogen receptor, lymphovascular invasion, local invasion of tumor, and number of tumors. Three prediction algorithms, with each using SVM, artificial neural network and Cox-proportional hazard regression model, were constructed and compared with one another. The resultant and most effective model based on SVM was compared with previously established prognostic models, which included Adjuvant! Online, Nottingham prognostic index (NPI), and St. Gallen guidelines. RESULTS: The SVM-based prediction model, named 'breast cancer recurrence prediction based on SVM (BCRSVM),' proposed herein outperformed other prognostic models (area under the curve=0.85, 0.71, 0.70, respectively for the BCRSVM, Adjuvant! Online, and NPI). The BCRSVM evidenced substantially high sensitivity (0.89), specificity (0.73), positive predictive values (0.75), and negative predictive values (0.89). CONCLUSION: As the selected prognostic factors can be easily obtained in clinical practice, the proposed model might prove useful in the prediction of breast cancer recurrence. The prediction model is freely available in the website (http://ami.ajou.ac.kr/bcr/).
Artificial Intelligence ; Breast ; Breast Neoplasms ; Estrogens ; Follow-Up Studies ; Hospitals, Teaching ; Humans ; Lymph Nodes ; Recurrence ; Retrospective Studies ; Risk Factors ; Sensitivity and Specificity ; Support Vector Machine

Pseudoaneurysm of the femoral artery is a rare complication following the fixation of the fracture of proximal femur or protruded bony fragment and reports injuring on superficial femoral artery is very rare compared to deep femoral artery complicated by the insertion of distal interlocking screw. The chance of injuring superficial femoral artery may increase by deep insertion of drill bit or the repetitive arterial pulsation on prominent distal interlocking screw tip during the perioperative period. Authors experienced one case of injury on the superficial femoral artery postoperative 42 hours followed by the use of proximal femoral nail advocated by the AO group recently and would like to call attention upon the possibilities of vessel injury complicated with the use of the distal interlocking screw.
Aneurysm, False* ; Femoral Artery* ; Femur ; Perioperative Period

BACKGROUND/AIMS: Although trials have suggested an association between osteoporosis and cardiovascular disease (CVD), the relationship between fracture risk and cardiovascular disease is not well defined. Here, we examined whether subjects with a higher risk of fracture also share an increased likelihood of developing CVD. METHODS: This study included 477 subjects; patients with a history of diabetes, chronic hepatopathy, nephritic syndrome, or any cardiovascular diseases were excluded. We used dual energy X-ray absorptiometry to assess the bone mineral density (BMD) of the lumbar spine and femur, and calculated fracture risk based on the Fracture Risk Assessment (FRAX) score. The Framingham risk score (FRS) was used to estimate cardiovascular risk. RESULTS: Of the 477 subjects, 222 had osteopenia and 150 had osteoporosis; the remaining 105 had a normal BMD. In men, no significant differences were observed in systolic blood pressure (SBP), diastolic blood pressure, low-density lipoprotein, high-density lipoprotein (HDL), and triglyceride (TG) between groups. Men with osteoporosis were generally older, and had significantly higher total cholesterol (TC). In women, age and FRS were significantly higher in the osteoporosis group. In the multivariate analysis, age, SBP, TC, HDL, TG, and FRAX were all significantly associated with FRS. CONCLUSIONS: These data suggest that patients with a higher risk of fracture are also at greater risk of developing CVD, indicating a possible mechanistic link between CVD and osteoporosis.
Absorptiometry, Photon ; Blood Pressure ; Bone Density ; Bone Diseases, Metabolic ; Cardiovascular Diseases ; Cholesterol ; Female ; Femur ; Humans ; Lipoproteins ; Male ; Multivariate Analysis ; Osteoporosis ; Risk Assessment* ; Spine ; Triglycerides

Adult ; Amyloidosis ; complications ; Factor X Deficiency ; complications ; Humans ; Liver Diseases ; complications ; Male

BACKGROUND: Methotrexate (MTX) has been used to treat a wide range of malignant and benign diseases including osteosarcoma, advanced stage non-Hodgkin's lymphoma, psoriasis, severe rheumatoid arthritis, sarcoidosis, and Wegener's granulomatosis. MTX-induced lung injury occurs in up to 10% of treated patients. Although both acute and chronic presentations have been described, typical manifestation of MTX-induced lung injury is subacute with symptoms usually developing within several months after starting therapy. Nonspecific interstitial pneumonia (NSIP) is the most common histopathologic manifestation of MTX-induced lung disease, while bronchiolitis obliterans organizing pneumonia (BOOP) and diffuse alveolar damage (DAD) are less common. Granuloma formation is reported in 34.7%. In Korea, Two reports of MTX pneumonitis have been published. The one presented with NSIP and the other with DAD. We recently experienced a case of MTX pneumonitis with presentation of hypersensitivity pneumonitis.
Alveolitis, Extrinsic Allergic* ; Arthritis, Rheumatoid ; Cryptogenic Organizing Pneumonia ; Granuloma ; Humans ; Hypersensitivity* ; Korea ; Lung Diseases ; Lung Diseases, Interstitial ; Lung Injury ; Lymphoma, Non-Hodgkin ; Methotrexate* ; Osteosarcoma ; Pneumonia ; Psoriasis ; Sarcoidosis ; Wegener Granulomatosis