Congenital fibrosarcoma of neonate is a very rare malignant tumor prone to behave aggressively with a tendency to local recurrence without metastasis. It is characteristically composed of collagenous fibroblasts and herringbone pattern in histology. We experienced a case of congenital fibrosarcoma on the left thigh and report this case with some review in literature with 1½ year follow up.
Collagen ; Fibroblasts ; Fibrosarcoma ; Follow-Up Studies ; Humans ; Infant, Newborn ; Neoplasm Metastasis ; Recurrence ; Thigh

It is generally recognized that immunosuppressive manifestations such as lymphopenia, granulocytosis, decreased transformation to various antigens and impaired neutrophil chemotaxis are followed by surgical operation. In connection with this, anesthetics were also targetted as the possible depressive agent in the immune mechanism. To elucidate the theories, the present study was carried out with patients who were subjected to surgical operation utilizing anesthesia by halothane inhalation. Lymphocytes, specially B-and T-cell lymphocytes were examine throughout the course from operation to 48 hours after the operation. In general, T-cells were decreased by operation with halothane anesthesia, and decrases of Helper-T cell and Inducing-T cell were prominent than suppressor T-cell or Killer T-cell. However, the decrases showed recovery from six hours after the operation, and reached to normal values in two days. The overall result in the study suggest that anesthesia utilizing halothane may bring potentially harmful effect on the immunologic responses to infectious diseases or malignant, but not systemic.
Anesthesia ; Anesthetics ; B-Lymphocytes ; Chemotaxis ; Communicable Diseases ; Halothane* ; Humans ; Inhalation ; Lymphocyte Subsets* ; Lymphocytes* ; Lymphopenia ; Neutrophils ; Reference Values ; T-Lymphocytes

No abstract available.
Abortion, Habitual* ; Female ; Immunization* ; Lymphocytes* ; Pregnancy

OBJECTIVES: The purpose of the study is to investigate the factors affecting adequate provision of mental health care services to the psychiatric patients in mental hospitals and to suggest the introduction of a new reimbursement schedule for treatment of chronic Medicaid patients in order to avoid long-term hospitalization and to meet rising cost. METHOD: Five hundred and seventy-five psychiatric patients chosen by the stratified random sampling in six hospitals in Korea; three mental hospitals and three general hospitals, have been classified into three groups: two groups were selected from mental hospitals with the national health insurance system and Medicaid, while only one group from general hospitals with the national health insurance system. They were investigated about mental health care services provided for one week, which are transformed into financial cost by using Korean Resource Based Relative Value Scale points. The severity of their psychiatric symptoms were assessed with RAI-MH(Resident Assessment Instrument-Mental Health). RESULTS: When the Medicaid was compared to the health insurance in mental hospitals, sixty-seven percent was the relative ratio. Mental hospitals compared to general hospitals under health insurance, it was only 31%. The longer the hospitalization, the lesser services they received in all three groups. CONCLUSION: The significant factors affecting supply of mental health care services in Korean mental hospitals were duration of hospitalization, type of hospital, type of reimbursement. The introduction of Medicaid system, differentiated by duration of stay, may induce short-term hospitalization and prohibit deficient service care, especially in acute patients under Medicaid system.
Appointments and Schedules ; Hospitalization ; Hospitals, General ; Hospitals, Psychiatric ; Humans ; Insurance, Health ; Korea* ; Medicaid ; Mental Health* ; National Health Programs ; Relative Value Scales

One of the sequelae of spinal cord trauma which start soon after the onset of injury is the loss of the calcium from bone. Bone mineral and matrix resorption causes negative calcium balance, and eventually osteoporosis. Etidronate disodium(etidronate) is an oral diphosphonate compound known to reduce bone resorption through the inhibition of osteoclasic activity. Since continuous oral treatment with high doses of etidronate may lead to the impairment of bone mineralization and the cessation of bone remodeling, a ideal therapeutic regimen consist of the intermittent cyclical administration of the diphosphonate in a dose that inhibits bone resorption. To assess the effect of etidronate on bone metabolism and bone mineral density after spinal cord injury, we studied two groups of 7 spinal cord injury(SCI) patients with etidronate and 7 SCI patients without etidronate. Seven patients of treatment group received oral etidronate (5 mg/kg/day) for 2 weeks followed by a 10-week period in which no drugs were given. This sequence was repeated 4 times, for a total of 48 weeks. The results showed that the patients receiving etidronate had siginificant decrease in the serum osteocalcin(OC), urine deoxypyridinoline(D-PYD) level but no increase in their mean bone density. We can carefully conclude that intermittent cyclical therapy with etidronate siginificantly reduces bone metabolic rate and inhibit bone mineral loss on osteoporosis in spinal cord injury patients.
Bone Density ; Bone Remodeling ; Bone Resorption ; Calcification, Physiologic ; Calcium ; Etidronic Acid* ; Humans ; Metabolism ; Osteoporosis* ; Spinal Cord Injuries* ; Spinal Cord*

From January 1988 to December 1991, 39 fractures of the lateral condyle of humerus in children were treated at the Department of Orthopaedic Surgery, Sung-Ac General Hospital. It was possible to follow up from one year to four years and eleven months. The authors have analyzed the method of treatment on the basis of the degree of displacement in the change of Carrying angle and Baumann's angle. The results were as follows; 1. Of the 39 cases, the age incidence was confined to 2 to 12 years of age and the average age of the patients were 5 years. 2. Most fractures were Milch type II (29 cases) in contrast to Milch type I (10 cases). 3. According to the initial displacement of the fracture, 8 cases were Jokob's stage I, 21 cases of stage II & 10 cases of stage III. 4. There were no significant difference in the range of change of Carrying angle and Baumann's angle according to initial displacement of fracture site. However, significant difference in outcome were noticed from open reduction and internal fixation in comparison to closed reduction and percutaneous pinning. 5. In all 39 cases, lateral condylar overgrowth (10 cases), cubitus varus (1 cases) and cubitus valgus (3 cases) were noticed as complications but clinical significance was not noted. 6. The above results suggest that internal fixation is recommended for firm fixation although displacement is not severe. In case of Jakob's stage III, anatomical reduction is required in order to reduce additional damage on articular surface and epiphyseal plate caused by excessive manipulation.
Child ; Clinical Study ; Follow-Up Studies ; Growth Plate ; Hospitals, General ; Humans ; Humerus ; Incidence ; Methods

Displaced fracture of the ankle are probably the most common skeletal injury managed today by open reduction and internal fixation. But, it is recommended that metallic implant might be removed to restore normal biomechanical forces on hone and to reduce discomfort directly under the skin. in order to reduce the resources needed for the removal of metallic fixation devices, absorbable impiants of biodegradable synthetic polymers were deveioped. However reports of clinical application of such implants have so far been very few. This prospective study represents the good resuits in 15 displaced non-comminuted closed malleolar fractures of the ankle treated using hiodegradahle internal fixation in department of orthopedic surgery of Kwang Myung Sung Ae general hospitai from June I 995 to December 1996. The results were as follows 1. All cases were united and the average time for union was 7.6 weeks. 2. As a results of comparison with normal side, a restriction of 10 degrees or more of dorsiflexion of the ankle joint was present in 4 cases, a restriction of 20 degrees or more of plantar tlexion was present in 2 cases, a restriction of supination was present in 3 cases and a restriction of plantar flexion was present in 4 cases. 3. According to Phillips functional scoring scale, 4 cases were excellent, 7 cases good, 4 cases fair and no cases were poor. 4. There were no complications in all cases.
Ankle ; Ankle Joint ; Orthopedics ; Polymers ; Prospective Studies ; Skin ; Supination

It is usually difficult to obtain an exact reduction of bony mallet finger involving more than one third of the articular surface by closed manipulation and extension splinting and needs the operative treatment to obtain an exact anatomical reduction. Operative treatment of a mallet finger is a difficult procedure, fraught with many potential problems, including intraoperative fragmentation of dorsal lip fracture, difficulty of exposure and anatomical reduction of the fragment, skin slough, and postoperative loss of fixation. The purpose of this study is to evaluate the fixation technique and to reduce intraoperative complications. We retrospectively reviewed 13 patients of bony mallet fingers, who were treated by tension wire fixation between January 1994 and August 1995 at the Department of Orthopaedic Surgery, Kwangmyung Sung Ae Hospital. There were 6 male and 7 female pateints. The most common cause was sports injury (6 cases). According to Wehbe and Schneider classification, 8 cases were type II and subtype B, 7 cases were the other types. According to modified Abouna and Brown criteria, the clinical results were success in 10 cases and failure in 3 cases. Postoperative complications were superficial infeciton (2 cases), skin necrosis (1 case), nail deformity (1 case) and secondary extensor tendon rupture (1 case). In conclusion, tension wire fixation of bony mallet finger was a simple and effective fixation of the fragment under the direct vision, which make it possible to exercise early and fix sturdily. But it should be avoided some pitfalls associated with internal fixation of small bony fragments.
Athletic Injuries ; Classification ; Congenital Abnormalities ; Female ; Fingers* ; Humans ; Intraoperative Complications ; Lip ; Male ; Necrosis ; Postoperative Complications ; Retrospective Studies ; Rupture ; Skin ; Splints ; Tendons

BACKGROUND: In the present study, we examined the effect of morphine on NO- and peroxynitrite-induced cell death using a human neuroblastoma SH-SY5Y cell line which abundantly expresses micro, delta and K-opioid receptors. METHODS: The cultured cells were pretreated with morphine (100 micrometer) and exposed to 3-morpholinosydnonimine (SIN-1, 1mM). Agarose gel electrophoresis of DNA was done with the extracts from SH-SY5Y cells. The cells were treated with selective ligands for opioid receptor subtypes and with PI3-kinase inhibitors. Cell damage was assessed by using an MTT assay. Spectrophotometric absorption spectra were measured from the mixture of morphine (100 micrometer) plus peroxynitrite (1 mM) at room temperature. RESULTS: SIN-1 treated cells showed the occurrence of a specific form of chromosomal DNA fragmentation which pretreatment with morphine inhibited. The selective ligands for opioid receptor subtypes, [D-Ala2, N-Me-Phe4, Gly-ol5]enkephalin (DAMGO, micro-opioid receptor agonist), [D-Pen2,5] enkephalin (DPDPE, delta-opioid receptor agonist) and U-69593 (K-opioid receptor agonist) at a concentration of 10 micrometer did not prevent the cell death induced by SIN-1. Naloxone (20 micrometer) hardly antagonized the effect of morphine in SIN-1-induced cell death. The PI3-kinase inhibitors Wortmannin and LY294002 did not inhibit the action of morphine on apoptotic cell death. In the measurements of spectrophotometric absorption spectra, the peak of the absorbance of the mixture of morphine plus peroxynitrite at 295 300 nm disappeared three minutes after mixing. CONCLUSIONS: The present study showed that morphine protected the human neuroblastoma cell line,SH-SY5Y, from peroxynitrite-induced apoptotic cell death. However, it is suggested that the protective action of morphine is not via the activation of opioid receptors and/or the PI3-kinase pathway but possibly via direct chemical reaction.
Absorption ; Cell Death ; Cell Line ; Cells, Cultured ; DNA ; DNA Fragmentation ; Electrophoresis, Agar Gel ; Enkephalins ; Humans* ; Ligands ; Morphine* ; Naloxone ; Neuroblastoma* ; Peroxynitrous Acid ; Phosphatidylinositol 3-Kinases ; Receptors, Opioid

This study is an attempt to investigate the effect of total Ginseng saponin (GTS) on the blood pressure of the rat and to elucidate its mechanism of action. GTS, when injeced into a femoral vein of the rat, caused dose-related fall in blood pressure with secondarily elevation of the blood pressure. The depressor effect of GTS was blocked by treatment of atropine and prazosin, but not affected by pretreatment with chlorisondamine or cyproheptadine. GTS inhibited significantly the pressor response evoked by norepinephrine. The pressor effect of GTS was not affected by treatment with atropine or cyproheptadine, but was attenuated markedly by pretreatment with chlorisondamine. From the above mentioned results, it is thought that GTS produces the pressor and the depressor actions in the rat, and that its depressor response is exerted partly through the stimulation of cholinergic muscaric receptors with the blockade of adrenergic alpha-receptors, and that its pressor response is revealed by stimulation of nicotinic receptors in autonomic ganglia.
Animals ; Atropine ; Blood Pressure* ; Chlorisondamine ; Cyproheptadine ; Femoral Vein ; Ganglia, Autonomic ; Norepinephrine ; Panax* ; Prazosin ; Rats* ; Receptors, Adrenergic, alpha ; Receptors, Nicotinic ; Saponins*