A total of 200 cases of metastatic bone tumors was treated at the Yonsei Medical Center during the 5 years period from January 1976 to December 1980. The results of clinical radiological and pathologic analysis are as followings. 1. Among 200 cases of metastatic bone tumors, common site of cancer comprised the lung (30.5%), breast (15.0%), uterus (8.5%), stomach (6.4%), thyroid (3.5%), liver (3.5%), kidney (3.5%), nasopharynx (3.0%), and prostate (2.0%). In male, common primary sites of cancer were lung, stomach, kidney, oropharynx in decreasing order of incidence and in female, breast, uterus and lung. 2. In metastatic bone tumors, 75.5% were observed in the age group between 41 and 70 year of age, and average age was 53.1 years. 3. The sex distribution was 107 males (53.1%) and 93 females (46.5%). 4. The bones affected most frequently in this series were as followings; In only 9 cases (4.5%), metastasis to bone distal to the elbows and knees occurred. 5. Clinical features in this series were classified according to various conditions. Bone pain noticed on 163 cases (81.5%), fatigue on 152 cases (76.0%) and weight loss on 128 cases (64.0%). 6. Pathologic fractures occurred on 22 cases (11.0%); among them, 13 cases on the femur, 5 cases on the vertebrae, and 1 case on the acetabulum, humerus, rib and clavicle respectively. 7. Hematologically, serum calcium and phosphorus was noticed within normal limits. Serum alkaline phosphatase was slightly elevated and serum acid phosphatase was elevated in all cases of prostatic carcinoma. Serum albumin/ globuline ratio was slightly reversed (3.4/3.5mg%). 8. Radiologically, 86 cases were osteolytic, 10 cases were osteoblastic and 44 cases were mixed type. False negative on X-ray examination with positive finding of scan with 99mTc-MDP were found in 17 cases (27.4%). 9. All cases was treated by various methods; among this series, radiation and chemotherapy performed in 57 cases, radiation in 49 cases, chemotherapy in 14 cases, hormone therapy in 16 cases and radioisotope therapy in 5 cases. For 22 pathologic fractures, conservative treatment was performed in 9 cases, open reduction and internal fixation in 13 cases, open reduction and internal fixation with acrylic cement in 5 cases.
Acetabulum ; Acid Phosphatase ; Alkaline Phosphatase ; Breast ; Calcium ; Clavicle ; Drug Therapy ; Elbow ; Fatigue ; Female ; Femur ; Fractures, Spontaneous ; Humans ; Humerus ; Incidence ; Kidney ; Knee ; Liver ; Lung ; Male ; Nasopharynx ; Neoplasm Metastasis ; Oropharynx ; Osteoblasts ; Phosphorus ; Prostate ; Ribs ; Sex Distribution ; Spine ; Stomach ; Technetium Tc 99m Medronate ; Thyroid Gland ; Uterus ; Weight Loss

Cubitus varus deformity caused usually by malunion in supracondylar fracture or epiphyseal injuries of the elbow joint, but the other causes of cubitus varus deformity have not been reported. 7 cases of cubitus varus deformity were found among the patients in Sam Yook Childrens Rehabilitation Center in Oct. 1981 all of whom used crutches in order to ambulate due to late sequele of poliomyelitis. The results were as follows. l. After long-term crutch walking, cubitus varus deformity and bowing around the proximal forearm were seen among the patients who mis-used the crutches. 2. Gross carrying angle was greater than radiographic carrying angle and it caused by hypertrophy of the extensor muscle group in forearm and bowing around the proximal forearm. 3. Etiologic factors of the cubitus varus deformity were considered to be improper measurement of the crutches, degree of paralysis of lower extremity and duration of the crutch walking, etc. 4. The mechanism of this deformity could be explained biomechanically by the abnormal axial loading onto the elbow following long-term crutch walking. 5. The correct measurement of the crutches and proper flexion of the elbow during crutch walking were stressed.
Child ; Congenital Abnormalities ; Crutches ; Elbow ; Elbow Joint ; Forearm ; Humans ; Hypertrophy ; Lower Extremity ; Paralysis ; Poliomyelitis ; Rehabilitation Centers ; Walking

Ossifying fibroma is one of a group of fibro-osseous lesion which arises typically within the jaw bone and only rarely affects the long bones. In 1966, Kempson described two patients with ossifying fibroma of the tibia, noting its unique, aggressive local behavior. This rare lesion resembles monostotic fibrous dysplasia, but can be differentiated from it on histologic and clinical ground. Histologically, ossifying fibroma is characterized by osteoblasstic rimming spicules of bone within a fibrous stroma with evidence of the lamella transformation of bone, and clinically by, frequent recurrence and aggressive progression of the lesion. We experieced three cases of ossifying fibroma, two cases in the tibia and one case in the fibula. In case 1, recurrence was developed after local curettage and bone graft, so reoperation was performed at 11 months after the first opecation. The 2nd case was healed after wide curettage and free vascularized fibula graft, and the 3rd case being followed up after segmental resection of the fibula.
Curettage ; Fibroma ; Fibroma, Ossifying ; Fibrous Dysplasia, Monostotic ; Fibula ; Humans ; Jaw ; Recurrence ; Reoperation ; Tibia ; Transplants

The purpose of this study was to perform the fetal education effectively for the delivered woman and her husband. This study was conducted by the questionnaire survey on 199 delivered women and their 171 husbands at several hospitals located in Seoul and Kyonggi Province from February 28 to March 26, 2002. The contents of questionnaire included the purposes, the cognition and the practice of fetal education. The SAS program was used for the statistical analysis of the data. The character of subject was analyzed by the percentage. The difference between the cognition and practice of fetal education was analyzed by t-test, ANOVA, Wilcoxon rank sum test. The factor analysis affected on the practice of fetal education was adopted by Multiple regression. The results were as follows; 1. In the purpose of fetal education, the well- balanced emotion showed the highest mark. The cognition of fetal education(woman:4.39 +/-0.52, husband:3.88+/-0.70) and the practice (woman:3.88+/-0.60, husband:3.83+/-0.70) showed the relatively high mark, but the score of cognition showed higher than that of practice. 2. In the comparison of the cognition between the delivered woman and the husband for the fetal education the item of the mental or health state would affect unborn baby, which occupied the highest mark in both woman and the husband(woman:4.81+/-0.44, husband :4.81+/-0.50). But they were prohibited to eat the deformed food, which showed the lowest mark(woman:3.19+/-1.12, husband:3.21+/-1.29).3. In the comparison of the practice for the fetal education between the delivered woman and the husband, the practice for the healthy baby showed the highest mark in woman (4.51+/-0.71), which had a statistically significant difference(P=0.025), compared with that of the husband(4.13+/-0.99).4. In the comparison of cognition and practice for the fetal education, the general character was associated with the duration of marriage, the satisfaction with marriage and the support of husband on pregnancy. The mark was associated with the age of woman, the level of education and the first birth.5. The significant factors influencing on the practice for the fetal education were connected with the cognition of fetal education, age, satisfaction with marriage, the support of husband on pregnancy, the type of family, the experience of delivery and the state of health during the period of pregnancy. etc. In conclusion, it is indicated to make effort for transforming and developing the traditional fetal education in accordance with the modern fetal education. And it is suggested that the fetal education might be recognized by all members of family, and the importance of husband's role for the fetal education should be informed as well as that of woman's.
Cognition* ; Education* ; Female ; Gyeonggi-do ; Humans ; Marriage ; Pregnancy ; Surveys and Questionnaires ; Seoul ; Spouses*

Among the 65 patients undergoing transurethral resection of the prostate from 1985 to 1988, the complication incidence was significantly higher in 25 patients whose weight of resected prostate was above 20 gm than in 40 patients below 20 gm (p<0.05). So to choose mote proper surgical method, the results of operation, motality and morbity of these 25 TURP patients were compared with 35 open prostatectomy patients whose weight of resected prostate was between 20 gm and 60 gm during same period. The mean incidence of complication for open prostatectomy (60%) was nearly twice that of the TURP (32%) (p<0.05). The age of the patient had no significant influence on the incidence of complication in both groups. In case of the weight of resected prostate below 40 gm complication incidence for the TURP (26.3%) was significantly lower compared with open prostatectomy(66.7%) (p<0.05), but in case of above 40 gm there was no significant difference in both groups. In case of the length of resection below 120 min complication incidence was significantly low in TURP (21.4%) compared with open prostatectomy (61.5%) (p<0.05), but in case of above 120 min. there was no significant difference in both groups. In the open prostatectomy there was no increase in complication incidence by the weight of the gland and the operation time, but in TURP, complicat,40 gm incidence was definitely increased when either weight of the resected prostate was above 40 gm or length of resection was above 120 minutes. Therefore, it seems that TURP is preferable surgical method for benign prostatic hypertrophy unless open surgery is necessarily indicated.
Humans ; Incidence ; Prostate ; Prostatectomy* ; Prostatic Hyperplasia* ; Transurethral Resection of Prostate

In 1960 Jacobson and Suarez introduced the operating microscope to vascular surgery and demonstrated the superiority of small vessel repair using magnification. The first clinical replantation of an arm in the western world was performed by Malt in 1962, and Komatsu and Tamai reported the successful replantation of a completely amputated thumb in 1965. To perform a digit or hand replantation, microsurgical anastomosis of blood vessels is absolutely essential to revascularize the severed part. Without accurate repair of bone, nerves and tendons in addition to vascular anastomosis, however, it is impossible to gain functional success when replanting a digit or hand. This is a difficult task because all structures must be reconstructed at the same level and time. Even if the repair of some structures has been postponed, the secondary reconstruction may also be troublesome due to circular scarring at the replantation level. Since replantation surgery has been popularized throughout the world in recent years, the replantation sucess rate has increased and the surgeons interest in functional reconstruction of replanted digits or hands has been stimulated. The authors have seen and studied 6 cases of upper Jimb and 20 cases of finger replantation from May, 1980 through January, 1982 at the department of orthopedic surgery, Yonsei University College of Medicine. The results were as follows: I. The average age was 20 years and the male to female sex ratio was 4.5:1. 2, The causes of injury are detailed as follows: electric saw(6); cutting machine(5); roller(4}; presser(2); stone(2); others(3). 3. The level of amputation in 26 replantations was as follows: thumb, 3 cases; index finger, 4 cases; middle finger, 9 cases; ring finger, 4 cases; palm, I case, wrist, 3 cases; forearm, 1 case; upper arm, 1 case. 4. The maximum ischemic times for successtul results were 16 hours in limb replantation and 22 hours in finger replantation. 5. Six limbs, with four complete and two incomplete amputations, have been replanted and all six limbs survived: Twenty digits, with nine complete and eleven incomplete amputations, have also been replanted and 6.5 cases of nine complete amputations and 10 cases ot eleven incomplete amputations survived. A total of 22.5 cases(86.5%) of replanted limbs and digits survived. 6. The results of joint motion, two point discrimination, sensory recovery and status of sweating due to recovery ot sympathetic nervous function following replantation were satisfactory. 7. In the early stage of our series, postoperative systemic heparinization was used in some cases, but recently we have achieved good recults without it. 8. Main causes of reattachment failure were tissue crushing and secondary thrombosis of the anstomosed vessels.
Amputation ; Arm ; Blood Vessels ; Cicatrix ; Clinical Study ; Discrimination (Psychology) ; Extremities ; Female ; Fingers ; Forearm ; Hand ; Heparin ; Humans ; Joints ; Male ; Orthopedics ; Replantation ; Sex Ratio ; Surgeons ; Sweat ; Sweating ; Tendons ; Thrombosis ; Thumb ; Western World ; Wrist

No abstract available in English.
Clinical Study ; Spondylolisthesis

A case of chondroma of soft tissue of right hand in 23-year old man was reported. The presenting symptom was a slow growing mass, causing mild tenderness. Radiologic examination revealed a well demarked and lobulated calcified mass, was located extraskeletally. Specimen exised from soft tisssue of the hypothenar area of the hand was 5×4×3.5cm sized mass, had gelatinous and gray-whitish appearance. On microscopical examination, the tumor was classified as a chondroma of soft tissue.
Chondroma ; Gelatin ; Hand

Ossifying fibroma is not a well recognized entity, and only rarely affects the long bones. The main differential diagnosis is with fibrous dysplasia and with adamantinoma, non-ossifying fibroma of the long bone. Ossifying fibroma seldom has even a moderate tendency to progress during childhood, but it recurs frequently after curettage or subperiosteal resection. Any progression of the lesion comes to an end after puberty. So, surgery should be delayed as long as possible. But, if the lesion is rapidly progressive, or if a patient has repeated fractures, it would be necessary to resort to wide extraperiosteal resection. We have experienced 7 cases of ossifying fibroma from Octover 1979 to November 1988. The results were as follows; 1. The male and female ratio, was 5 to 2 and six patients were at their first decade, and one patient was 13 years old. 2. The lesion site was six cases in the tibia, one case in the fibula. 3. In six patients, we had done wide resection with free-vasculaized fibular graft in five cases and wide resection of the distal one-third of the fibula in one case. Two patients among them had recurrence. One case of recurrence was performed incomplete wide resection with free vascularized fibular graft because the lesion was too close to the distal epiphysis of the tibia.
Adamantinoma ; Adolescent ; Curettage ; Diagnosis, Differential ; Epiphyses ; Female ; Fibroma ; Fibroma, Ossifying ; Fibula ; Health Resorts ; Humans ; Male ; Puberty ; Recurrence ; Tibia ; Transplants

OBJECTIVE: Ruptured vertebrobasilar (VB) saccular aneurysm is a difficult lesion to treat, and is associated with high rates of morbidity and mortality. The aim of this study is to investigate the risk factors associated with the clinical outcome of ruptured VB aneurysms. METHODS: A retrospective review of 29 patients with ruptured VB saccular aneurysms between 2002 and 2010 was conducted between Jan 2002 and Dec 2010. Univariate and multivariate analyses were performed for determination of the statistical significance of the Glasgow Outcome Scale (GOS) at three months, according to age, initial Hunt-Hess grade, the presence of acute hydrocephalus, and treatment modality. RESULTS: The study included 24 (82.7%) females and five (17.3%) males, with a mean age of 59 years (range, 22-78 years). Seventeen patients were treated with surgical clipping and 12 patients were treated with endovascular coil embolization. No statistical significance was observed between clinical outcome and treatment modalities (clipping or coiling; p = 0.803). Seventeen (58.6%) patients achieved favorable outcome, defined as GOS score of 4-5, at 3 months. Procedure-related complications occurred in seven patients (24.1%). Results of multivariate analysis indicated that initial Hunt-Hess grade and the presence of acute hydrocephalus were independent predictors of unfavorable outcome, defined as GOS score of 1-3 (Odds ratio (OR) = 8.63, Confidence interval (CI) [95%] 1.11-66.84, p = 0.039 and OR = 36.64, CI [95%] 2.23-599.54, p = 0.012, respectively). CONCLUSION: The present study suggests that the clinical outcomes are related to the initial Hunt-Hess grade and the presence of acute hydrocephalus in ruptured saccular VB aneurysms.
Aneurysm ; Female ; Glasgow Outcome Scale ; Humans ; Hydrocephalus ; Male ; Multivariate Analysis ; Retrospective Studies ; Risk Factors ; Surgical Instruments