Limb salvage operation in primary malignant bone tumors is increasing recently, according to the improvement of diagnostic methods, surgical technique and adjuvant chemotherapy. The purpose of this study is to obtain the interim results of survival rate and the functional grade of the limb in primary malignant bone tumors treated by limb salvage operation. Between 1985 to 1993, 63 primary malignant bone tumors treated by limb salvage operations. Tumor prosthesis arthroplasty was performed in 49 patients, resection arthrodesis in 9 patients, and IM nailing with cement molding in 5 patients. Autoclave autograft was combined in 2 patients. Adjuvant chemotherapy and postoperative radiotherapy were performed in selected patients. The average follow-up period was 50 months(ranged 12 months to 116 months). In the cases of osteosarcoma, estimated survival rate was 61.9% based on Kaplan-Meier survival plot. In the parosteal sarcoma, the survival rate was 87.5% and 80% in chondrosarcoma patients. According to functional grading by Enneking, 66% was excellent, 20% was good, 11% was fair and one patients was poor. Complications occurred in 16 patients:wound infection was developed in 6 patients, local recurrence in 4, peroneal nerve palsy in 2 patients and femoral stem loosening in 2 patients. Fracture in resection arthrodesis and pulmonary metastasis were also occurred. Reoperation was performed in 10 patients at average 31 months after initial operation. Revision tumor persthesis arthroplasty was performed in one patient due to local recurrence and in 2 patients due to femoral stem loosening. Three amputations were done due to recurrence of tumor. IM nailing with cement molding was performed in one patient due to deep infection and repeated arthrodesis was done in a fracture patients. Scheduled custom-made tumor prosthesis arthroplasty was performed within a year in 2 patients treated with IM nailing with cement molding. In conclusion, with the careful preoperative assessment, adjuvant chemotherapy and skillful surgical technique, limb salvage operation would provide the primary malignant bone tumor patients for longer survival and better quality of life.
Amputation ; Arthrodesis ; Arthroplasty ; Autografts ; Chemotherapy, Adjuvant ; Chondrosarcoma ; Extremities ; Follow-Up Studies ; Fungi ; Humans ; Limb Salvage ; Neoplasm Metastasis ; Osteosarcoma ; Paralysis ; Peroneal Nerve ; Prostheses and Implants ; Quality of Life ; Radiotherapy ; Recurrence ; Reoperation ; Sarcoma ; Survival Rate

Takayasu's arteritis is the chronic inflammatory panarteritis of unknown pathogenesis, affecting aortic arch and main arotic branches, pulmonary and renal arteries. It mainly affects young oriental women and cause chronic ischemic injury to tissues of the brian, orbits, upper limbs, myocardium, and kidneys. The ophthalmologic features are tend to be late the manifestations of Takayasu's arteritis and include ischemia of the retina, choroid, and anterior segment. We experienced two cases of Takayasu's arteritis whose ipsilateral ophthalmic artery was completely occluded. yet maintained proper visual acuity by external carotid-ophthalmic anastomosis.
Aorta, Thoracic ; Choroid ; Female ; Humans ; Ischemia ; Kidney ; Myocardium ; Ophthalmic Artery ; Orbit ; Renal Artery ; Retina ; Takayasu Arteritis* ; Upper Extremity ; Visual Acuity

An intraosseous epidermal cyst is a rare benign cystic lesion. It is thought to result from congenital factors or trauma and can lead to bone destruction because the cyst develops at the soft tissue around the bone. Radiological findings of intraosseous epidermal cysts are a well-defined radiolucent lesion, with cortical expansion. It is important to differentiate an intraosseous epidermal cyst with other disease developed at distal phalanx because its clinical and radiological findings are similar. We report two rare cases of intraosseous epidermal cysts that developed at the distal phalanx.
Epidermal Cyst*

From 1986 to 1995, 75 eyes of 75 patients who were admitted with a diagnosis of infectious corneal ulcer at Chunbuk university hospital were analyzed on the etiologic agents and clinical findings. Etiologic agents of infectious corneal ulcer were classified as 49 bacterial ulcers(65.3%) and 26 fungal ulcers(34.7%). The most common isolated bacteria was 8 cases of coagulase negative staphylococcus and pseudomonas species was the most common isolated gram negative organism. Candida species was the most commonly isolated fungus. Hypopyon was noted in 30 cases(40%) of infectious corneal ulcers, 14 cases in small ulcer group and 16 cases in large ulcer group. There was no difference between severity and presence of hypopyon of the 75cases (P>0.05. chi-square test).
Bacteria ; Candida ; Coagulase ; Corneal Ulcer* ; Diagnosis ; Fungi ; Humans ; Pseudomonas ; Staphylococcus ; Ulcer

Granulosa cell tumor of the testis is extremly rare in adult males and granulosa cell tumor occurring in the paratesticular area has not been reported. We report a paratesticular granulosa cell tumor in a 34-year-old man who presented with a 5.5 cm sized scrotal mass. The tumor was present in the paratesticular area near the head of epididymis. It was located in the tunica and completely separated from the testis by thick fibrous tissue. Microscopically, the tumor exhibited solid, microfollicular, and trabecular patterns. The tumor cells had ovoid to elongated nuclei with longitudinal intranuclear grooves and one or two nucleoli and scanty cytoplasm. Mitoses were relatively frequent with an average number of 9/10 HPFs. The tumor extended into the visceral tunica vaginalis and showed multiple lymphatic tumor emboli. Immunohisto chemical stains revealed diffuse strong positivity for inhibin, vimentin, and keratin and diffuse weak positivity for estrogen and progesteron receptor. Placental alkaline phosphatase (PLAP) and epithelial membrane antigen (EMA) were negative. On electron microscopic examination, tumor cells were polygonal and had large indented nuclei. The cytoplasm contained a moderate number of small round mitochondria, abundant rough and smooth endoplasmic reticula, and a few lipid droplets. Small aggregates of intermediate filaments and intercellular junctions were observed. The patient was alive and well 5 months after orchiectomy. This is the first case of adult granulosa cell tumor arising in the paratesticular area.
Adult ; Alkaline Phosphatase ; Coloring Agents ; Cytoplasm ; Epididymis ; Estrogens ; Female ; Granulosa Cell Tumor* ; Granulosa Cells* ; Head ; Humans ; Inhibins ; Intercellular Junctions ; Intermediate Filaments ; Male ; Mitochondria ; Mitosis ; Mucin-1 ; Orchiectomy ; Testis ; Vimentin

Purpose: The goal of this study was to evaluate the efficacy of suction drains following total hip arthroplasties, by comparing the post-operative results between the group with suction drains and the group without suction drains. Materials and Methods: Eighty-six patients, who underwent primary total hip arthroplasties from June 2001 to June 2004, were divided into two groups: group 1 (48 patients), with suction drains; and group 2 (38 patients), without suction drains. We assessed the perioperative hemoglobin and platelet levels, the amount of total blood loss, the amount of post-operative blood transfusions, post-operative ranges of motion (ROMs, at 6 weeks), wound problems, and general conditions. Results: Although the postoperative hemoglobin level was greater in group 2 than in group 1, there was no statistically significant difference. The amount of total blood loss and blood transfusions in group 1 were statistically greater than in group 2 (p<0.05). There were no statistically significant differences in the post-operative ROMs and wound complications between groups 1 and 2. Conclusion: There were no limitations of hip motion and no wound complications in the patients without suction drains after total hip arthroplasties. However, they required fewer post-operative blood transfusions than did the patients with suction drains, due to less post-operative blood loss; and the absence of a suction drain might prevent retrograde tube infections. In addition, patients without suction drains after total hip arthroplasties seemed to recover better did than those with suction drains. Therefore, suction drains might provide no benefit in total hip arthroplasties.
Arthroplasty ; Arthroplasty, Replacement, Hip* ; Blood Platelets ; Blood Transfusion ; Hip ; Humans ; Suction* ; Wounds and Injuries

The geriatric population tends to increase, worldwidely, and the same in orthopedic fields. In this age group, senile changes, both physical and mental, appear. In addition, psychiatric problems due to retirement from the job and changes of the role in his society and in the family, are included. The geriatric orthopedics is peculiar and its importance is increasing, which makes great demands on both medical and surgical skills as well as an enthusiastic teamwork. Fifty six patients over the age of 70, who were admitted and treated at the Department of Orthopedic Surgery, Seoul National University Hospital, between 1986 to 1987, were analysed. The results were as follows. 1. Thirth four patiens were female and twenty two were male. 2. The fracture was the most common cause, and degenerative arthritis, tumor are the next causes. 3. Operation was performed in 38 cases. 4. The associated diseases were hypertension, diabetes, U.T.I., renal failure, poor sight, pulmonary and cardiovascular diseases, which were more common than other age group. 5. Intra or postoperative complications were hypertension, liver function abnormalities, renal and respiratory failures and et al., which were also more common. 6. Old age is a major risk factor for surgery, but is not a contraindication, so careful evaluation and managements are needed, which can be done by specialized geriatric orthopedic team.
Cardiovascular Diseases ; Female ; Humans ; Hypertension ; Liver ; Male ; Orthopedics ; Osteoarthritis ; Postoperative Complications ; Renal Insufficiency ; Retirement ; Risk Factors ; Seoul

OBJECTIVES: The aim of this study was to evaluate the associations between vasomotor symptoms and factors such as sociodemographics, health behaviors, medical condition, depression, stress, anxiety, attitude toward menopause, and quality of life. METHODS: We conducted a cross-sectional study in peri- and post-menopausal women enrolled by the Korean Association of Health Promotion. Subjects submitted self-report questionnaires about vasomotor symptoms and other clinical symptoms. Associations between vasomotor symptoms and clinical variables were analyzed using stepwise multiple regression analyses. RESULTS: 1951 women completed self-report questionnaires and 1022 women were enrolled in the study. The prevalence of vasomotor symptoms in peri- and post-menopausal women was 63.9%. Variables showing significant differences between subjects with vasomotor symptoms and subjects without them were score of Beck Depression Inventory, Brief Encounter Psychosocial Instrument-Korean Version, proportions of clinically significant depression(Beck Depression Inventory≥16), Menopausal rating scale, attitude towards menopause, the 4 subscales of World Health Organization Quality of Life-BREF(Physical health, psychological, social relationships, environment), and a History of Premenstrual syndrome/Premenstrual dysphoric disorder. Stepwise multiple regression analyses indicated that Beck Depression Inventory, Brief Encounter Psychosocial Instrument-Korean Version, Menopausal Rating Scale, and the Psychological subscale of World Health Organization Quality of Life -BREF show associations with vasomotor symptoms. CONCLUSIONS: Menopausal vasomotor symptoms are associated with various psychological factors, especially with depression. Midlife women suffering vasomotor symptoms should therefore be screened for depression. Future prospective studies where clinical subjects are diagnosed using structured interviews, focusing on the causal relationship between depression and vasomotor symptoms are necessary.
Anxiety ; Cross-Sectional Studies ; Depression* ; Female ; Health Behavior ; Health Promotion ; Humans ; Menopause ; Prevalence ; Prospective Studies ; Psychology ; Quality of Life* ; World Health Organization

BACKGROUND: Abnormal serum gamma-glutamyltransferase (gamma-GT) may be an early and sensitive marker for oxidative stress. This study was performed to evaluate the association between serum heavy metals and gamma-GT concentration. METHODS: This study is a cross-sectional analysis based on data from Korean National Health and Nutrition Examination Survey (V-1, 2, 2010, 2011) regarding serum heavy metal concentrations (lead, mercury, and cadmium) as well as serum gamma-GT. Serum heavy metals were categorized into tertiles, and serum gamma-GT concentration was compared using an analysis of covariance test after relevant variable adjustments. In addition, we evaluated the odds ratio (OR) of having the highest tertile of serum gamma-GT in each heavy metal tertile using logistic regression. RESULTS: The mean serum lead, mercury, and cadmium concentrations were 2.67, 5.08, and 1.02 microg/dL in men and 1.95, 3.60, and 1.21 microg/dL in women, respectively. Partial correlation showed a significant positive relation between each heavy metal and serum gamma-GT concentration. Comparing serum gamma-GT concentration by the tertile of each heavy metal, serum gamma-GT concentration showed a significant increase as the tertiles of serum mercury and cadmium in men and that of serum mercury in women increased, but not with lead. The OR of having the highest tertile of serum gamma-GT was significant for cadmium in men (OR, 4.02; 95% confidence interval [CI], 2.54 to 6.35) and mercury in women (OR, 2.00; 95% CI, 1.29 to 3.10) in the top tertile of each heavy metal. CONCLUSION: Higher serum heavy metal concentration may be related with higher serum gamma-GT concentration. In particular, serum cadmium in men and mercury in women showed significant correlation with serum gamma-GT concentration.
Cadmium ; Cross-Sectional Studies ; Female ; gamma-Glutamyltransferase* ; Humans ; Korea* ; Logistic Models ; Male ; Metals, Heavy ; Nutrition Surveys* ; Odds Ratio ; Oxidative Stress

No abstract available.
Cryptococcosis* ; Lung Neoplasms* ; Lung*