It is socially fortunate that there is little chance in the civil hospital to experience the victims of high velocity missiles. However it is reasonable thought to educate doctors about the gunshot and explosive injuries who might be mobilized in emergency condition. Authors have experiences to treat the high velocity missile wounds. In order to provide valid data to be an educational material, we clinically analyzed 41cases of those injuries who were treated at the Capital Armed Forces General Hospital from 19xx to 19xx. The results obtained were as follows: 1. In 15 cases there were only soft tissue injuries, The remaining 26 cases had the bone injuries and six of them had two injury sites. 2. In 28 cases the lower extremities were injuried, and they out-numbered the injury of upper extremities. The most frequent site of injuries was the thigh (31.7%). 3. Most common associated injuries were the periphenal nerve injuries, which numbered 10 cases. 4. The early operative treatments were given in 5 out of 32 cases having bone injuries. And the secondary operations, including bone graft and intemal fixation, had to be done in 10 out of the remaining 27 cases due to delayed union or nonunion. 5. There was no infection in cases having only the soft tissue injuries. But the localized osteomyelitis occurred in 4 cases among the cases having bony injuries. 6. Factors affecting the result of high velocity missile wounds were presence of bony involvement, site and extent of injuries, associated thoracoabdominal injuries and presence of peripheral nerve injuries and infection. 7. The evacuation time, chance of early adequate wound management, site of injury and extent of injury were the important factors in deciding the method of treatment. We suggest that the more selective and aggressive measures should be taken in the management of bony injuries.
Arm ; Emergencies ; Extremities ; Hospitals, General ; Lower Extremity ; Methods ; Osteomyelitis ; Peripheral Nerve Injuries ; Soft Tissue Injuries ; Thigh ; Transplants ; Upper Extremity ; Wounds and Injuries

The experiment was performed to investigate changes of maternal immune status during the pregnancy. We observed the distribution of several immune cells [macrophage, activated B-cell, IgM+ B-cell, Lyt-2+ T-cell and L3T4+ T-cells] in the utero-placental interface and the peripheral blood of Balb/c mice. The experimental animals were divided into seven groups by the gestational ages ; virgin, 2nd, 5th, 8th, 10th, 14th and 19th day of pregnancy. In the utero-placental interface, the distribution patterns of the lymphocytes [both T and B] and macrophages were observed. Histochemical staining by naphthol-AS-MX phosphate sodium salt was used for the detection of activated B-cells. For the detection of macrophage, plasma cell, suppressor cell and helper cell, all the prepared samples reacted with Rat anti-mouse Mac-1, goat anti-mouse IgM, rat anti-Lyt2 and rat anti-L3T4 antibody first, and washed. Second reaction was done with biotinylated anti-rat or anti-mouse IgG anti-bodies, and washed. Avidin-biotin -peroxidase complex and 3, 3`-diamino-benzidine[DAB] were used for the visualization of specific cells. T-cells and B-cells were not observed during the all stages of pregnancy. By contrast, macrophages were observed a few at the perimetrium on the second day of gestation, and they were found at the outermost portion of the trophoblastic layer on the 8th day, and they were observed at the decidua basalis in late pregnancy after the 10th day when the placenta were well developed. In the peripheral blood, activated B-cells were not observed throughout the pregnancy. On the 8th day, the proportion of plasma cells to total mononuclear cells was decreased significantly to 16+/-2.4% compared with the virgin group[22+/-2.6%][p<0.01]. It increased again and it reached 42+/-5.8% on the 14th day and 37+/-4.9% on the 19th day. Helper T-cells were decreased on the 14th day[30+/-2.4%] compared with the normal control[47+/-5.1%]. But, Suppressor T-cells were increased on the 8th day[35+/-2.9%] and the 10th day[33+/-3.6%] compared with the normal controls[27+/-2.3%]. This decrement returned to the level of the normal controls on the 14th day and 19th day. Together with our previous data, we could find the synchronized changes of immune cells in utero-placental interface, uterus draining lymph nodes, peripheral blood and spleen. Therefore, we suggest that macrophages in utero-placental interface may play an important role for the immune responses against the fetal transplantation antigen.
Animals ; B-Lymphocytes* ; Decidua ; Female ; Gestational Age ; Goats ; Immunoglobulin G ; Immunoglobulin M ; Lymph Nodes ; Lymphocytes ; Macrophages* ; Mice* ; Placenta ; Plasma Cells ; Pregnancy ; Rats ; Sodium ; Spleen ; T-Lymphocytes ; T-Lymphocytes, Helper-Inducer ; Trophoblasts ; Uterus

No abstract available.
Facial Nerve* ; Paralysis* ; Temporal Bone*

No abstract available.
Facial Paralysis* ; Humans

TO evaluate the histopathologic features of gastric mucosa by Helicobacter pylori (HP), we reviewed 70 endoscopically biopsied chronic gastritis and peptic ulcer. The results are as fonows. l. HP was detected in 923% (48/52) of active gastritis, 8l8% (9/l l) of peptic ulcer and l43% (1/7) of chronic gastritis. The prevalence of HP infection was significantly higher in active gastritis and peptic ulcer than chronic gastritis (P<0005). 2. The infiltration of intraepithelial neutrophil of the 58 HP-positive cases was significantly more than of the l2 HP-negative cases (P<0005). 3. The infiltration of neutrophil and chronic inflammatory cells in the lamina propria of the 58 HP positive cases were significantly more than of 12 HP-negative cases (P<0.005, P<0.01) 4. The gastric epithelium of 58 HP positive case showed characteristic degenerative change, such as epithelial pits (93.l%), irregular surface (84.4%), individua1 cell drop-out (46.5%) and microerosion (27.6%). The similiar changes were not seen in l2 HP-negative cases. In summary, HP is significantly correlated with inflammatory reaction of the gastric mucosa. It is also significantly correlated with the epithelial degenerative changes that is considered to the precursor of peptic ulcer.

Pathologic fracture occurs in a bone with preexisting stuctual weakness. The author reviewed 30 cases of pathologic fractures in which admission record and X-ray finding was well preserved among 53 cases admitted patients in the department of Orthopaedic Surgery, Seoul National Universty Hospital for 10 years from 1967. The results were as follows: 1.Age & Sex incidence showed even distribution. 2. The most frequent involved site was femur (40%) 3. The underlying etiology was as follows: 2 chronic osteomyelitis 1 homophilia 7 benign tumor 20 malignant tumor 4. metastatic tumor was the most frequent cause in 30 cases. 5. Treatment was as follows: Conservative treatment 4 cases Surgery 21 cases.
Clinical Study ; Femur ; Fractures, Spontaneous ; Humans ; Incidence ; Osteomyelitis ; Seoul

No abstract available.
Dislocations ; Spine

Pancreatic ductal rupture can be an elusive diagnosis. The early signs and symptoms are often vague, and when it goes unnoticed, ductal rupture results in inceased morbidity and mortality. Unfortunately, no diagnoatic test has proven reliable in its timely detection. Endoscopic retrograde cholangiopancreatography (ERCP) is routinely utilized to visualize the anatomy of the pancreatic duct in elective situation. But the utilization of emergent ERCP will allow detection of pancreatic rupture in clincal settings where surgery might not otherwise have been prompted by complications. In addition, present, timely visualization of the pancreatic duct will permit intelligent planning for pancreatic sugery. Recently, we experienced a case of 36-year-old female who had upper abdominal blunt trauma with heavy iron. Her serum amylase was high but the physical examination was vague. Emergent ERCP was performed and it revealed dye leak from rurptured pancreatic duct at tail portion of pancreas. Emergent distal pancreatectomy and splenectomy was successfully performed. So we report this case with a review of literatures.
Adult ; Amylases ; Cholangiopancreatography, Endoscopic Retrograde* ; Diagnosis ; Female ; Humans ; Iron ; Mortality ; Pancreas ; Pancreatectomy ; Pancreatic Ducts ; Physical Examination ; Rupture ; Splenectomy

No abstract available.
Catheters*

OBJECTIVES: This study was designed to investigate the prevalence of depressive symptoms in patients with breast cancer and to identify demographic variables and clinical characteristics impact on depressive symptoms and health related quality of life in patients with breast cancer in a university hospital. METHODS: Fourty-one patients with breast cancer were selected, who had visited the department of General surgery of the Wonkwang University hospital with a diagnosis of breast cancer regularly during the period November, 2010-May, 2011. All of subjects were evaluated for the depression, anxiety and the health related quality of life with Beck Depression Inventory(BDI), anxiety subscale of Personality Assessment Inventory(PAI) and Short-Form 36 Health Survey-Korean version(SF-36-K). Patients were divided into depressive symptoms and non-depressive symptoms group according to the BDI score. We compared SF-36-K between two groups, and analized multiple regression with depression and health related quality of life as criterion variables and demographic and clinical characteristics. RESULTS: The prevalence of depression in patients with breast cancer in a University hospital was 36.4%. Compared to the non-depression, depressed patients with breast cancer appeared significantly lower mean scores on six subscales in SF-36-K : Physical function(p<.01), Role-physical(p<.001), General health(p<.05), Social function(p<.001), Role-emotional(p<.001) and Mental health(p<.001). But there was no significant difference between two groups in Vitality and Bodily pain. Anxiety, level of education and presence of enforcement of chemotherapy(63.6%) were significant explanation variables for depressive symptoms. And type of surgery and age (55.8%) were significant explanation variables for health related quality of life. CONCLUSIONS: The prevalence of depressive symptoms in patients with breast cancer in a University hospital was 36%. The depressive symptoms had not only negative impact on the health related quality of life but also important explanation variable for health related quality of life. These results suggest that depressive symptoms in patients with breast cancer should be evaluated and treated for improving patient's health related quality of life.
Anxiety ; Breast ; Breast Neoplasms ; Depression ; Humans ; Personality Assessment ; Prevalence ; Quality of Life