No abstract available.
Anemia, Iron-Deficiency* ; Iron* ; Milk*

Osteosarcoma is the most common primary malignant tumor in the orthopaedic field. Recently, the management of osteosarcoma was evolved in many aspects and the improved results were reported in many articles. The purpose of this study is to evaluate the changes of clinical findings and management modalities in osteosarcoma since 1980. We reviewed 127 osteosarcomas managed from 1980 to 1992. The Enneking surgical stage was as follows; stage I 12 cases, stage II 98 cases and stage III 17 cases. They were subclassified into classic(97 cases), parosteal(12 cases), telangiectatic(5 cases), secondary(4 cases), periosteal(2 cases), gnathic(2 cases), high grade surface(1 cases) and undetermined(4 cases). The disease-free survival rate was evaluated for the patients of stage II classic osteosarcomas treated with amputation(27 cases) or limb-salvage operation(23 cases), and average follow up period of them was 49 months. In 27 cases of amputation adjuvant chemotherapy was administered in 23 cases. And in 23 patients treated with limb-salvage operation, neoadjuvant and adjuvant chemotherapy were done in 19 cases and only adjuvant chemotherapy in 2 cases. The clinical changes since 1980 were as follows: (1) The mean duration from symptom onset to diagnosis was decreased gradually from 6.5 months(1980) to 3.1 months(1992). (2) The proportion of curative surgery was increased from 40%(1980) to 87%(1992) in stage I and II. (3) The proportion of limb-salvage operation was rapidly increased upto 88% since 1985. The 5 year disease-free survival rate of stage II classic osteosarcoma was 36% with amputation and 67% with limb-salvage operation.
Amputation ; Chemotherapy, Adjuvant ; Diagnosis ; Disease-Free Survival ; Follow-Up Studies ; Humans ; Osteosarcoma

There were 21 cases of tibial pilon fractures in total: type I-2 cases, type II-14 cases, type III-5 cases according to Rued's classification. In type I and II, ring fixators were applied to tibia and foot and closed reduction was performed monitoring the quality of the reduction with an image intensifier. When the quality of the reduction was questionable, we rechecked it using arthroscopy and if neces- sary, the reduction was readjusted. Instead of using plate and screws, we used olive stop wires to achieve stable fixation. In type III, a limited open reduction was performed in the place of arthroscopy. Approximately at the eighth week after operation, we removed the fixation of calcaneus, metatarsal and foot mounting. Between 16 and 28 weeks, we removed the foot mounting after achieving bony union in all cases except one case(20 cases). In the follow-up cases of 2 years and more, we obtained the fine functional results of 15 good, 4 fair and 2 poor cases. Fewer major complications were observed except 8 cases of pin tract infection(grade 1) and 1 case of reduction loss. Using ring fixators and arthroscopy, we had fewer surgical complications.
Arthroscopy ; Calcaneus ; Classification ; Follow-Up Studies ; Foot ; Metatarsal Bones ; Olea ; Tibia

Cavernous hemangioma is about one-tenth as common as capillary hemangioma, although congenital, is often not apparent at birth and may undergo a rapid growth phase during the 6 months of life. It arises from skin layers to muscles, bones or central nervous system. Cavernous hemangioma is much less likely to undergo spontaneous involution and tends to have a more aggressive course, and may result in complications related to its location. The authors experienced a case of atypical cavernous hemangioma which arose from the left parotid gland at adult onset, its size was wax and wane without any symptoms or complications and its shape was characteristically dumbbell-like, so report this case with a review of literatures.
Adult ; Central Nervous System ; Hemangioma, Capillary ; Hemangioma, Cavernous* ; Humans ; Muscles ; Parotid Gland* ; Parturition ; Skin

STUDY DESIGN: A retrospective study. PURPOSE: To evaluate the prevalence and risk factors of asymptomatic cervical or thoracic lesions in elderly patients who have undergone surgery for lumbar spinal stenosis. OVERVIEW OF LITERATURE: Concurrent multiple spinal lesions have been reported in many studies with a varied prevalence, and described the characteristics of the disease and its treatment options. However, the cervical or thoracic lesions without apparent symptoms in patients with symptomatic lumbar stenosis had not been evaluated. METHODS: A total of 101 elderly patients (aged 65 or more), who had undergone surgery for lumbar spinal stenosis from January 2005 to December 2005, were enrolled in this study. All patients underwent lumbar magnetic resonance imaging (MRI) along with T2-weighted cervical and thoracic sagittal MRI prior to surgery. The concurrent cervical or thoracic lesions were classified according to the disease entity, and the severity of the lesions was graded from grade 0 (no lesion) to grade 4 (any lesion compressing the cord with a signal change). The prevalence of concurrent cervical and thoracic lesions was then analyzed. In addition, the risk factors for the development of concurrent lesions were evaluated, and the risk factors affecting the severity of the concurrent lesion were analyzed individually. RESULTS: Seventy-seven (76.2%) and 30 (29.7%) patients had a concurrent cervical and thoracic lesion, respectively. Twenty-six patients (25.7%) had both a cervical and thoracic lesion. There was a positive correlation between the symptom duration of lumbar stenosis and the prevalence of both cervical (p = 0.044) and thoracic (p = 0.022) lesions. CONCLUSIONS: The incidence of asymptomatic cervical or thoracic lesions is apparently high in elderly patients who have undergone surgery for lumbar spinal stenosis, particularly in those with longer symptom duration. This highlights the need for a preoperative evaluation of the cervical and thoracic spine in these patients.
Aged ; Constriction, Pathologic ; Humans ; Incidence ; Magnetic Resonance Imaging ; Prevalence ; Retrospective Studies ; Risk Factors ; Spinal Stenosis ; Spine

OBJECTIVE: Our purpose was to investigate the distribution of the result of 17,744 cervicovaginal smears and their pathologic results in Inha University Hospital to make a reference data. METHODS: During 28 months, May 1996 to August 1998, we performed 17,774 cervicovaginal smears and arranged them by the Bethesda system and compared them with their pathologic results. RESULTS: Among 17,744 smears, there were 93.2% of benign results, 2.9% of ASCUS, 0.9% of LSIL, 1.4% of HSIL, and 0.8% of SCC. The ASCUS/SIL ratio was 1.28. Among ASCUS, the high grade histologic outcome was composed 4.0%. Among LSIL, there were 15.7%, and HSIL 48.0%, SCC 56.1%, AGUS 9.3%, and Adenocarcinoma, the results was 69.2%. CONCLUSION: Among 17,744 smears, there were 93.2% of benign results, 2.9% of ASCUS, 0.9% of LSIL, 1.4% of HSIL, and 0.8% of SCC. The ASCUS/SIL ratio was 1.28. These results were very similar to other data and we would like to add our data to them as a reference. And the worse the smear results were, the worse the pathologic results were.
Adenocarcinoma

Except for special situations, it is generally agreed that best results in the treatment of facial fractures is expected if reduction is done within the first 2 or 3 weeks after injury. We reduced facial bone fractures at 4 to 7 weeks after trauma. A 44-year-old female patient underwent open reduction for her right zygomaticomaxillary complex fracture at 7 weeks after injury. A 59-year-old female patient underwent surgery for the right mandible body and left parasymphysis fractures at 4 weeks after injury. Using traditional approaches, granulation tissue and callus were removed from the fracture sites, and malunited fracture lines were separated by a small osteotome. We reduced the displaced fractured zygoma and mandible to their normal anatomical positions and fixed them using titanium plates. No complications such as asymmetry, malunion, malocclusion, or trismus were seen. Unfavorable asymmetric facial contours were corrected, and we obtained good occlusion with favorable bony alignment. The functional and aesthetic outcomes were satisfactory. Through removal the callus and limited osteotomy, a successful approach to the previously fractured line was possible, and an exact correction with symmetry was obtained. This method can be a good option for obtaining good mobility and clinical results in treating delayed facial bone fractures.
Adult ; Bony Callus ; Facial Bones* ; Female ; Fractures, Malunited ; Granulation Tissue ; Humans ; Malocclusion ; Mandible ; Mandibular Fractures ; Middle Aged ; Osteotomy ; Titanium ; Trismus ; Zygoma ; Zygomatic Fractures

The necessity of embracing selective courses in medical curriculum is increasing due to the expansion of medical knowledge and changes in the health care environment. In contrast to the abundant evidence regarding elective or selective courses during the clinical phase, articles focusing on the preclinical period are relatively scarce. This study aims to explore the development, implementation, and evaluation of newly-adopted selective courses in the first-year medical curriculum in a medical school which recently underwent a major curricular revision. First of all, the Curriculum Committee established goals and operating principles of the courses, and then the committee encouraged all participating professors to attend a related faculty development workshop after finalizing the list of courses. A survey was conducted at the end of each course for evaluation. Of the 36 courses opened in 2016, the overall satisfaction of students was 4.98±1.06 (out of 6) and showed a strong correlation with students' previous expectations, reasoning- and participation-oriented teaching, and outcome of the courses including increased motivation. In the open-ended responses, students and professors described not only intended outcomes such as acquisition of medical knowledge and increased interest in new topics, but also unintended outcomes including positive impression for selective courses and even high satisfaction and rewarding experiences, especially from the teachers' perspective. Although long-term outcomes remain to be seen, the results of this study show the feasibility and impact of selective courses and will contribute to effective implementation in other medical schools.
Curriculum ; Delivery of Health Care ; Education ; Humans ; Motivation ; Reward ; Schools, Medical

No abstract available.
Biomarkers* ; Leukemia, Myeloid, Acute*

Desmoplastic small round cell tumor (DSRCT) is a rare, aggressive neoplasm that preferentially involves the abdominal and pelvic cavities in relatively young males. We present a rare case of DSRCT arising in the ovary of a 16-year-old girl. During surgery, a 15 cm-sized huge mass was noted in the right ovary and wide spreading of the tumor was identified in the left ovary, uterine wall, and omentum and bowel wall. Histological investigation showed nests of small round cells with round nuclei and scanty eosinophilic cytoplasm accompanied with dense desmoplastic stroma. The immunohistochemistry showed that the tumor coexpressed epithelial, mesenchymal, and neuronal markers. The tumor cells ultrastructurally showed poorly developed cell junctions and occasionally showed intracytoplasmic aggregates of intermediate filaments. Molecular analysis of the tumor revealed chromosomal translocation t(11:22)(p13;q12) associated with the EWS-WT1 fusion protein. DSRCT should be included in the differential diagnosis of ovarian neoplasms in young patients.
Adolescent ; Cytoplasm ; Desmoplastic Small Round Cell Tumor ; Diagnosis, Differential ; Eosinophils ; Female ; Humans ; Immunohistochemistry ; Intercellular Junctions ; Intermediate Filaments ; Male ; Neurons ; Omentum ; Ovarian Neoplasms ; Ovary ; Translocation, Genetic