Inverted Papilloma arising from mucous membrane of the nasal cavity and paranasal sinuses is rare benign neoplasm, and usually unilateral arise from lateral wall of nasal cavity. This tumor is histologically benign neoplasm but clinically malignant, because of frequent recurrence and extensive bone destruction. And occasionally, this tumor can be transformed to squamous cell carcinoma or verrucous carcinoma. Recently, we have experienced a case of the inverted papilloma with verrucous carcinoma of the nose and paranasal sinuses and patient expired due to extension of intracranial cavity. We report out case with review of current literatures.
Carcinoma, Squamous Cell ; Carcinoma, Verrucous* ; Humans ; Mucous Membrane ; Nasal Cavity ; Nose* ; Papilloma, Inverted* ; Paranasal Sinuses* ; Recurrence

Thoracic outlet syndrome is a collective term embracing previously described syndromes such as scalenus anticus, cervical rib, costoclavicular, hyperabduction and shoulder girdle compression syndromes. Its symptoms and signs are due to bony and soft tissue compression of the neurovascular bundle at the thoracic outlet. It is the purpose of this paper to evaluate the results of experience in treating the patient with thoracie outlet syndrome by surgical means. In this study, 3 cases: cervical rib (1 case), excessive callus formation after clavicular fracture (1 case), and hyperabduction syndrome with combined scalenus anticus syndrome (1 case), which had developed thoracic outlet syndrome were treated at Severance Hospital and gratifying results were obtained.
Bony Callus ; Cervical Rib ; Humans ; Shoulder ; Thoracic Outlet Syndrome

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

Fracture of the posterior lumbar ring apophysis or vertebral cartilaginous end plate is unusual, having previously been described only in adolescent males. In this report, we present 3 such cases involving 2 adolescent males and 1 adolescent female. All patients had a bony ridge or fragment projecting into the spinal canal, usually from the lower border of L4 vertebral body; a defect in the posteroinferior aspect of the vertebral body. Preoperative myelogram and computerized tomogram including plain X-ray appear to be helpful in demonstrating bone within the canal and preoperative diagnosis can facilitate selection of the appropriate surgical approach. The radiographic findings, including the myelogram and computerized tomographic appearance are detailed and the previous literatures are reviewed.
Adolescent ; Diagnosis ; Female ; Humans ; Male ; Spinal Canal

Amputation is an unpleasant affair, generating a very negative aura that must be consciously combated. For optimal care of amputation, the surgeon needs not only to be comprehensive trained in reconstructive surgery but also to be knowledgeable about prosthetics. The evolution of an artificial arm can be traced first from the cosmetic prosthesis, then to that with passive movements, and lastly to an artificial limb with active movement which made it possible to restore to some degree the lost function of the amputation limb. But the gap between basic requirement of function and cosmesis is still present in conventional prosthesis. Myoelectric prosthesis was introduced for upper extremity amputees since 1960 by Korbinski and his co-workers and was most exciting improvement in the field of prosthetics. Two patients of bilateral above-elbow and bilateral below-knee amputees with myoelectric prostheses and conventional prostheses were compared in their function, cosmesis and acceptability of patient. Myoelectric prosthesis shows not only favorable cosmesis but also excellent function in range of motion and coordination of mechanical joints. And myoelectric prosthesis provides superior pinch force and requires less energy expenditure than a body-powered conventional prosthesis. So, in spite of the high cost of the appliance and of continued maintenance and repair, improvement in comfort, cosmesis and function have had to good level of acceptance of patients. Further research will undoubtedly improve the appearance, function and durability of the present electrically powered myoelectric prosthesis, making them even more acceptable and useful to lower limb and upper limb amputees.
Amputation ; Amputees ; Artificial Limbs ; Energy Metabolism ; Epilepsy ; Extremities ; Humans ; Joints ; Lower Extremity ; Prostheses and Implants ; Range of Motion, Articular ; Upper Extremity

From March 1983, 20 patients had undergone reconstruction of the upper limb with 22 vascularized composite tissue grafts. The microsurgical procedures had several advantages for reconstruction of injured upper limbs as follows: 1. Free tissue transfer was quite an important and attractive procedure for reconstruction of an injured limb, expecially an upper limb. 2. Free vascularized transfer of composite tissue with its overlying skin was a reliable technique to obtain full thickness soft tissue coverage of a severely injured upper limb when more conservative procedures, such as the use of skin graft or local muscle flaps, had failed or were not feasible. 3. A simple skin flap could be transfered to close an open wound of the limb, but a sensory flap or a special flap such as a nail-skin, tendon-skin or muscle-skin flap was a much better donor for reconstructing the function of the upper limb. 4. When appropriate, the wrap-around procedure was the method of choice for thumb reconstruction because the great toe was preserved. The procedure provided length, stability and adequate sensibility for a functional pinch and grasp. 5. The cosmetic effect of a second-toe transplant might be inferior to the wrap-around flap, but it had the great advantage of being able to provide mobile joints in the reconstructed thumb. As far as the donor foot was concerned, no patients had real trouble functional impairment.
Extremities ; Foot ; Hand Strength ; Humans ; Joints ; Methods ; Microsurgery ; Skin ; Thumb ; Tissue Donors ; Toes ; Transplants ; Upper Extremity ; Wounds and Injuries

Eosinophilic granuloma of bone, characteristically a disease of children and young adults, is the most benign variant of histiocytosis X. This benign bone destructive lesion is characterized by the presence of a histiocytic and eosinophilic leukocyte infiltrate of unknown origin. It was described as a new distinct entity by Jaffe and Lichtenstein(1940). we reviewed the ll patients with eosinophilic grnuloma of bone from January 1980 to December 1985. The average length of follow-up was 20 months, with a range of 10 to 38 months. The results were as follows. l. Incidence was 2.24% of primary bone tumor. 2. Male patient was more predominent. 3. Age of onset was between 2 and 16 years old. 4. Predilection sites were spine, skull, pelvis and femur in order. 5. Solitary lesion was more comon(63.5%). 6. Onset of multiple lesions was earlier age. 7. There was on recurrence of lesions.
Age of Onset ; Child ; Eosinophilic Granuloma ; Eosinophils ; Femur ; Follow-Up Studies ; Histiocytosis, Langerhans-Cell ; Humans ; Incidence ; Leukocytes ; Male ; Pelvis ; Recurrence ; Skull ; Spine ; Young Adult

Eleven cases of the free vascularized bone graft have been performed in the Department of Orthopaedic Surgery, Yonsei University Hospital during the period of 30.9 months from February 1981 to December 1985. Follow up ranges from 8 to 62 months. The indication for the procedure was reconstruction of extensive bony defect after acute trauma in 3 cases, osteomyelitis in 3 cases, chronic nonunion 3 cases, bone tumor in one case and congenital pseudoarthrosis in one case. The results were obtained as follows; 1. To reconstruct the lower extremity the vascularzed bone graft has much more advantages than the other conventional method and the technique may be very useful in the management of certain difficult reconstructive problem of the lower extremity. 2. In the defects of bone and skin, even infected, composite bone and soft tissue transfer can be filled by one stage operation and made the infection heal more rapidly. 3. In children the vacularized fibular graft was hypertrophied and similar to thickness of tibia.
Child ; Follow-Up Studies ; Humans ; Lower Extremity ; Methods ; Osteomyelitis ; Pseudarthrosis ; Skin ; Tibia ; Transplants

Thoraic outlet syndrome is a collective term in which symptoms and signs are due to bony and soft tissue compression of the neurovascular bundle at the thoracic outlet. It is the purpose of this paper to evaluate the results of treatment of patients with thoracic outlet syndrome by surgical methods. In this study, 7 cases, comprised of cervical rib (3 cases), excessive callus formation after clavicular fracture (2 cases), and scalenus anticus syndrome (2 cases), which had developed thoracic outlet syndrome were treated at Severance Hospital and good results were obtained.
Bony Callus ; Cervical Rib ; Humans ; Thoracic Outlet Syndrome