BACKGROUND: Recently the number of elderly gallstone patients has increased, in Korea. The aim of this study is to analyze and to measure the risk factors associated with operation on elderly gallstone patients. METHODS: We reviewed the medical records of 206 gallstone patients who had been admitted and operated on in the department of general surgery. Konkuk University Hospital, between January, 1993 and December, 1999. The patients were divided into 2 groups, over and under age 65. In each group, analysis was done on sex distribution, the ratio according to location of gallstone, duration of hospital stay, duration of general anesthesia and operative mortality, and then the above factors of each group were compared. RESULTS: 1) The ratio of common bile duct stones in patients over age 65 was two times of that in patients under age 65(48%,24%) 2) The overall operative mortality was 1.9% and has no correlation with old age. 3) Severe coexisting disease may seem the risk factor for operative mortality. CONCLUSION: In the diagnosis and management of gallstones in the elderly, the possibility of common bile duct stone should be suspected. And in order to reduce the operative mortality, careful preoperative evaluation and treatment of coexisting disease should be done.
Aged ; Anesthesia, General ; Common Bile Duct ; Diagnosis ; Gallstones* ; Humans ; Korea ; Length of Stay ; Medical Records ; Mortality ; Risk Factors ; Sex Distribution

During 1st and 2nd trimester, placenta accreta is rarely found and is not easy to diagnosis during these trimester. From time to time placenta accreta is found after induced abortion or spontaneous abortion. We had experienced a case of placenta increta which was found about 50 days after D&C due to missed abortion at local clinic. So we presented it with a brief case history and brief review of the concerned literatures.
Abortion, Induced* ; Abortion, Missed ; Abortion, Spontaneous ; Diagnosis ; Dilatation and Curettage ; Female ; Humans ; Placenta Accreta* ; Placenta* ; Pregnancy

Four cases of testicular embryonal cell CA and one case of testicular teratoma in childhood are presented, and related literatures are reviewed.
Teratoma

Cutaneous larva migrans(CLM) is a ubiquitous self-limiting skin eruption which has intensely pruritic, serpiginous, raised, sharply demarcated, red lesions. It is most frequently caused by larvae of dog and cat hookworms. We report two typical cases of cutaneous larva migrans that appeared as pruritic exanthems in two people after they had travelled in Southeast Asia. It is suggested one should consider cutaneous larva migrans in the differential diagnoses of erythematous pruritic lesions.
Ancylostomatoidea ; Animals ; Asia, Southeastern ; Cats ; Diagnosis, Differential ; Dogs ; Exanthema ; Larva ; Larva Migrans* ; Skin

Freys syndrome is characterized by attacks of facial erythema and gustatory sweating occurring in the cutaneous distribution of the auriculotemporal nerve. After sugery, trauma, abscess, or other diseases of the parotid gland, the postganglionic sympathetic and parasympathetic nerve fibers are disrupted. Some misdirected auriculotemporal nerve fibrils join with the distal sympathetic nerves innervating the sweat glands and subcutaneous vessels. We report a case of Freys sindrome in a 6-year old boy without any definite injury to the parotid gland. After considering our case and review of literature of Freys syndrome in children, we conclude that there may be a congenital defect in the auriculotemporal nerve innervation responsible for cases occuring in children.
Abscess ; Child* ; Congenital Abnormalities ; Erythema ; Humans ; Male ; Nerve Fibers ; Parotid Gland ; Sweat Glands ; Sweating, Gustatory

Pigmentary demarcation lines are borders of abrupt transition between more deeply pigmented skin and that of lighter pigmentation. We describe two patients with pigmentary demarcation lines associated with pregnancy symrnetrially involving the buttocks and flexor as jects of legs. Hormonal changes in pregnancy and compression by the enlarged uterus of Sl and S2 peripheral nerves may be responsible for these changes.
Buttocks ; Humans ; Leg ; Peripheral Nerves ; Pigmentation ; Pregnancy* ; Skin ; Uterus

The experience of a replacement surgery of ankylosed elbow joint by the Shiers chrome-cobalt hinge prosthesis is introduced with a brief review of literatures.
Arthroplasty ; Elbow Joint ; Elbow ; Prostheses and Implants

The result of clinical survey of seventy-five children with supracondylar fractures of the humerus is presented. Sixty-eight fractures had gross displacement, and seven were undisplaced ones. Seven children with undisplaced fractures were treated with simple splinting. Twenty-one fractures with gross displacement were closedly reduced and immobilized by cast. Twenty cases treated with over-head skin traction or skeletal traction, and followed by cast immobilization, and twenty-seven were operatively reduced and were fixed with 2 K-wires. The results obtained were as follows: 1. The average age of children was 6.8 years, and the male and female ratio was 2.1:l. 2. 97.1% (66 cases) was the extension type and 2.9% (2 cases) was the flexion type. 3. Good end results were obtained in the well-reduced groups, such as undisplaced fractures and surgically reduced fractures. Of 27 operated cases, 19 who had early operation without manipulative trial or traction, had excellent results, while 8 who had surgery in delay developed limitation of flexion and/or extension motion of the elbow. Of these 19, two cases developed mild extension limitation as sequella. 4. As complications, incomplete ulnar nerve palsy developed in one case, but it spontaneously recovered in 3 weeks after open reduction. During treatment utilizing the olecranon pin traction, pin tract infection developed in 2 cases, but the infection was controlled by the antibiotic administration and wound dressing. Severe cubitus varus deformity developed in 4 cases among the conservatively treated group (manipulatively reduced group and skeletal traction group). These 4 children had corrective osteotomy. Mild deformity was the inevitable one when it is treated conservatively. Limitation of elbow motion developed in 23 cases (32%) as a sequella. 5. Fracture healed mostly in three weeks after reduction and immobilization. Average hospital stay for conservatively treated patients was 17.2 days, whereas that for surgically treated patients was 5.8 days in average. 6. Early anatomical reduction by any means whether it is surgical or nonsurgical, proved to be only the methods which bring the satisfactory results, and minimize the sequellae.
Bandages ; Child ; Congenital Abnormalities ; Elbow ; Female ; Humans ; Humerus ; Immobilization ; Length of Stay ; Male ; Olecranon Process ; Osteotomy ; Skin ; Splints ; Traction ; Ulnar Neuropathies ; Wounds and Injuries

Clinical observation was made on 131 cases of the unstable spine injury treated at the Orthopedic Surgery Department of Busan National University Hospital during the period from January 1974 to December 1981. The results obtained were as follows: 1. More than two-thirds of patients were between the age of 20 and 40, and the proportion of males to females showed a ratio of 5.9 to 1. The most common cause of injury was falling at an industrial area, rating 64.1% of all cases. 2. Fracture level was observed 31.3% in the first lumbar level, 24.4% in the twelfth thoracic vertebra, and 67.9% between the twelfth thoracic vertebra and the second lumbar vertebra. 3. Mechanisms of injury were 44.3% by pure flexion, 26.7% by flexion and rotation, 15.3% by direct shearing force, and 13.7% by vertical compression. 4. The fracture with lower extremity paralysis was due to the rotational fracture dislocation, which comprised 66% of all. 5. Kyphosis increased to the average of 10.6 degree in the case of decompressive laminectomy and of 3.4 degree in the case of spinal fusion. 6. The anatomical alignment and a definite stability could be obtained by the use of Harringtons rod in the cases of the unstable thoracolumbar fracture and fracture-dislocation. In 3 cases of all, we could get satisfactory results 1 month after the day injury occured. 7. In case of complete paralysis of lower extremity, it was found only 9.4% showed partial recovery, neurologically, and 61.9% of the patients with incomplete paralysis were also partly recovered. 8. The most common complication was urinary tract infection, which comprised 83% of the cases. With the use of intermittent urinary catheterization, the voiding reflex recovered within 4 months in most cases.
Accidental Falls ; Busan ; Dislocations ; Female ; Humans ; Kyphosis ; Laminectomy ; Lower Extremity ; Male ; Orthopedics ; Paralysis ; Reflex ; Spinal Fusion ; Spine ; Urinary Catheterization ; Urinary Catheters ; Urinary Tract Infections

PURPOSE: In young male patients who suffered several kinds of trauma with subsequent suspicious reflex sympathetic dystrophy syndrome, we performed three-phasic bone scan in order to investigate its usefulness. MATERIALS AND METHODS: Patients with narrow range of age (21-25. mean 22.8+/-1.3, all male) were included with suspicious reflex sympathetic dystrophy syndrome of 12 feet and 5 hands. Only one was bilateral feet case and 16 were ipsilateral (Rt:13, Lt:3). The etiologic traumas were 4 fractures, 4 sprains, 3 blunt trauma, 2 cellulitis, 1 tendon tear, 1 crush injury, 1 overexercise, and 1 unknown. Radiologically 3 showed osteoporotic changes. Three-phasic bone scans were performed 21.2+/-7.3wks after trauma. RESULTS: According to symptom complex, confirmatory reflex sympathetic dystrophy syndrome 4 cases and suspicious 13 were analyzed. All confirmatory cases (100%) showed increased uptake at delay phase with periarticular accentuation. Of confirmatory 4 cases, 2 showed increased uptake in all three phases (perfusion: P, blood pool: B, and delay: D), and other 2 revealed decreased P but, both increased B and D. Of suspicious 13 cases, 9(69.2%) had increased D (4 periarticular and 5 focal), 2 decreased D, and 2 symmetric D. In 12 foot cases, so-called weight bearing patterns - increased contralateral sole at P and B - were revealed in 7(58.3%). CONCLUSION: Diffuse periarticular increased uptake at delay phase of three-phasic bone scan was a compatible finding to reflex sympathetic dystrophy syndrome in young male patients whose symptom complex strongly designated post traumatic reflex sympathetic dystrophy syndrome.
Cellulitis ; Foot ; Hand ; Humans ; Male* ; Reflex Sympathetic Dystrophy* ; Reflex* ; Sprains and Strains ; Tendons ; Weight-Bearing