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

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*

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

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

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

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

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

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

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

BACKGROUND: The glomerular filtration rate (GFR) decreases with age, while parathyroid hormone (PTH) increases. There are a few reports only on the relationship between GFR and PTH under the category of serum 25-hydroxyvitamin D (25[OH]D) concentration. METHODS: Using the Korea National Health and Nutrition Examination Survey (KNHANES) data, a cross-sectional study was conducted on the association between serum 25(OH)D concentration, GFR and PTH in Korean adults aged 50 years or older. Serum PTH concentration was compared to the tertiles of GFR after adjustment for relevant variables. In addition, the serum PTH concentration was compared with the GFR under the category of serum 25(OH) D concentration (<20, 20-30, >30 ng/mL). RESULTS: The mean estimated GFR (eGFR) was 74.8 mL/min in men and 73.1 mL/min in women. The mean PTH and 25(OH) D was 66.8 pg/mL, 20.5 ng/mL in men and 69.0 pg/mL, 18.2 ng/mL in women. The serum PTH concentration showed a significant negative correlation with the serum 25(OH) D and eGFR in both genders. The serum PTH concentration significantly increased at the lower tertile of eGFR in male adults In addition, a decrease of serum PTH concentration was marked in the vitamin D sufficient male adults (>30 ng/mL). CONCLUSION: This present study demonstrated that serum PTH concentration showed negative correlation with eGFR, however, serum PTH increase may be minimized by maintaining proper serum 25(OH)D concentrations under similar eGFR status in Korean adults aged 50 and above.
Adult* ; Cross-Sectional Studies ; Female ; Glomerular Filtration Rate* ; Humans ; Korea* ; Male ; Nutrition Surveys* ; Parathyroid Hormone* ; Vitamin D