No abstract available.
Malingering*

External fixators are popular in treatment of the open fractures of long bones, especially tibia, associated with soft tissue injury, because they prevent further injury to the injured soft tissue and bone. Over the past ten years, bilateral frame external fixtors such as Hoffmann system had been used for lower extremity lesions. But they had many disadvantages like that bilateral frames were less rigid in A-P plane bending moment mechanically, therefore unilateral frame external fixators such as Monofixateur have been introduced recently. The Monofixateur was able to fix the fracture rigidly and compress, distract and neutralize the fracture site and could be used as a static and dynamic stabilizer. We have treated 19 cases using Monofixateur of the Gotzen type for open fractures of lower extremity from October 1984 to Febrary 1987. The summary of the results obtainained from this study are as follows : 1. Monofixateur was easy to use, simple and light. It provided a rigid stability to fracture. 2. It was possible to allow static stabilization on the unstable fracture, whereas dynamic stabilization on the stable fracture. 3. Application was easier than any other type of external fixators from the view point of using a few screws and unilateral frame, therefore it could prevent further soft tissue injury and was easy to secondary operation. 4. It was possible to use for short fracture fragment of the proximal or distal fractures of the long bone. 5. The fracture healing time averaged 32.5 weeks and there were marked differences of the fracture healing time between open type I, II and III fractures. 6. There was little complication such as pin tract infection and ankylosis of the joint.
Ankylosis ; External Fixators ; Fracture Healing ; Fractures, Open ; Joints ; Lower Extremity ; Soft Tissue Injuries ; Tibia

No abstract available.
Knee Joint* ; Knee*

Paraneoplastic pemphigus is a distinct and rare autoimmune disease characterized by extensive and painful mucosal ulcerations and polymorphic desquamated skin lesions in the setting of an underlying neoplasm, typically of lymphoreticular origin. Thus difficulties in the management of anesthesia can be expected. A 66-years-old man was scheduled for removal of intraabdominal sarcoma associated with paraneoplastic pemphigus. Physical examination showed multiple erythematous bullae, crusts, plaques and target-like lesions on the whole body and desquamated erythematous skin lesions on the back and extremities. In the operating room, his right femoral artery was cannulated with a 20 G, 12.7 cm CVP catheter and left femoral and subclavian veins with 14 G, 20 cm CVP catheters, respectively. After application of 4 % lidocaine spray, his oropharynx and supraglottic area were evaluated under direct laryngoscopy and revealed multiple ulcerations on oral mucosa, but no distinct lesion on supraglottic area. Anesthesia was induced by rapid-sequence method with fentanyl, thiopental sodium and succinylcholine followed by endotracheal intubation. The endotracheal tube was held by a roll gauze around the neck and its cuff was minimally inflated to avoid overpressure against his tracheal wall. After the end of surgery, his oral cavity was suctioned with no remarkable bleeding, and tracheal wall including cuff-contacted area was evaluated under fiberoptic bronchoscopy, revealed intact wall without any bulla or ulceration. The patient was transferred to intensive care unit for proper postoperative management after extubation of endotracheal tube.
Anesthesia ; Autoimmune Diseases ; Bronchoscopy ; Catheters ; Extremities ; Femoral Artery ; Fentanyl ; Hemorrhage ; Humans ; Intensive Care Units ; Intubation, Intratracheal ; Laryngoscopy ; Lidocaine ; Mouth ; Mouth Mucosa ; Neck ; Operating Rooms ; Oropharynx ; Pemphigus* ; Physical Examination ; Sarcoma ; Skin ; Subclavian Vein ; Succinylcholine ; Suction ; Thiopental ; Ulcer

A 24-year-old female was seen with multiple, pinkish to skin colored and brownish to black pigmented macules, papules, patch and plaque on the face, neck, upper chest, extensor surface of both forearms and dorsal hands. Histopathological diagnoses from the 75 skin biopsy specimens taken during the follow-up period of 22 months include 29 skin tumors : one malignant melanoma, one precancerous melanosis, 16 basal cell carcinamas, four squamous cell carcinomas, four actinic keratoses, one melanoacanthoma, one keratoacanthoma and one angiofibroma. It was discussed that melanoacanthoma would be considered as the one of the associated beniign skin tumors in xeroderma pigmentosum.
Angiofibroma ; Biopsy ; Carcinoma, Squamous Cell ; Diagnosis ; Female ; Follow-Up Studies ; Forearm ; Hand ; Humans ; Ichthyosis* ; Keratoacanthoma ; Keratosis, Actinic ; Melanoma ; Melanosis ; Neck ; Skin* ; Thorax ; Xeroderma Pigmentosum* ; Young Adult

No abstract available.
Humans ; Otitis Media* ; Otitis*

No abstract available.

PURPOSE: This study was done to compare breast feeding rates and factors influencing feeding practice between late preterm (34< or =GA<37) and preterm infants (GA<34). METHODS: A survey was done of 207 late preterm and 117 preterm infants in neonatal intensive care units (NICU) of 4 university hospitals in D city. Data were collected from July 2009 to June 2010 from 324 medical records in the NICU. Breast-feeding at home was checked either by telephone survey or questioning during hospital visits. RESULTS: Rate of breast feeding for late preterm infants was significantly lower than for preterm infants. There was no significant difference in breast-feeding at home. We found differences in factors influencing breast feeding between the two groups. Factors influencing feeding for late preterm infants were type of delivery, mothers' occupation, feeding type during hospitalization, time elapse from hospital discharge, total admission days, infant's body weight at first feeding and length of NPO (nothing by mouth). Factors influencing feeding for preterm infants were birth order, maternal disease and obstetric complications, and one-minute Apgar score. CONCLUSION: Results of the study show low rates of breast-feeding for late preterm infants indicating a need for breast-feeding education for mothers of these infants.
Body Weight ; Breast Feeding/*statistics & numerical data ; Female ; Gestational Age ; Humans ; Infant, Newborn ; Infant, Premature ; Intensive Care Units, Neonatal ; Interviews as Topic ; Length of Stay ; Male ; Mothers/*psychology ; Occupations ; Time Factors

No abstract available.

Renal oncocytoma has been recently defined histopathologically but many controversies have arised about its origin and differential diagnosis. Until the present time nearly all renal oncocytoma were considered to be benign nature, but rare cases have been reported to be metastasized. We reported a case of renal oncocytoma and synchronous contralateral renal cell carcinoma treated by radical nephrectomy on one side and enucleation on the other side.
Adenoma, Oxyphilic* ; Carcinoma, Renal Cell* ; Diagnosis, Differential ; Nephrectomy