Acrocephalosyndactyly is one of the more unusual and interesting errors of nature (Congenital anomaly) found in the human race. This syndrome was first described by Apert in 1906. Since that time, over 200 cases have been reported. The purpose of this article is to report an additional case along with review of provious literatures.
Continental Population Groups ; Humans

Twenty three leprous wrist drop hands had been operated for reconstructive surgery at the department of orthopedic surgery Presbyterian Hospital during the period from 1965 to 1972. The follow up study was carried out on twelve hands from six months to 82 months and was evaluated by the following assessments. 1. Function 2. Appearance 3. Environmental use and patients satisfaction in result The results were as follows 1. Satisfactory result was 84.1% in function, 66.7% in appearance, 75% in environmental use and patients satisfaction, and 75.3% in overall total assessment. 2. As complication, a case of adhesion of the transfered tendon was noted. 3. Preoperative and postoperative physiotherapy contributed an important roll in the end results.
Follow-Up Studies ; Hand ; Humans ; Orthopedics ; Protestantism ; Tendons ; Wrist

Tuberculous lymphadenitis is easily mistaken for an infection by only mycobacterium tuberculosis. However, many cases reveal atypical mycobacterium. Treatment of atypical mycobacterium differs from that of M. tuberculosis and M. bovis. Usual anti-tuberculous medication is the response to M. tuberculosis and M. bovis, but not to atypical mycobacterium. Excision and antibiotic therapy is the known treatment of choice for atypical mycobacterium. We used the polymerase chain reaction(PCR) for differential diagnosis of tuberculosis from lymphadenitis, and by using PCR we were able to differentiate the infecting organism as typical or atypical mycobacterium. We excised 50 case of cervical lymphadenitis, and PCR was done with Primer I(IS6110), which is specific for M. tuberculosis and M. bovis, and with Primer II(65 KDa Ag), which covers all mycobacterium species. The results obtained by PCR were compared with the pathologic results(control): sensitivity 81.8%, specificity 88.9%, false positive ratio 11.1%, false negative ratio 18.2%, typical mycobacterium 45.5%, and atypical mycobacterium 45.5%. These findings suggest that PCR is a good diagnostic tool for the early detection of tuberculous lymphadenitis and for differentiation of mycobacteria in cervical lymphadenitis.
Diagnosis, Differential ; Lymphadenitis ; Mycobacterium ; Mycobacterium tuberculosis ; Nontuberculous Mycobacteria* ; Polymerase Chain Reaction* ; Sensitivity and Specificity ; Tuberculosis ; Tuberculosis, Lymph Node*

Costoclavicular syndrome is one of the four syndromes of thoracic outlet syndrome in which have similiar symptoms, and may result from cervical and thoracic scoliosis, formation of excessive callus or nonunion after fractures of clavicle or first rib. Conservative treatment may be offered. Surgical treatment includes scalenectomy with supraclavicular approach, transaxillary first rib resection with scalenectomy and correction of clavicular abnormality. The purpose of this paper is to evaluate the result of surgical intervention in costoclavicular syndrome of a 38-year old man with clavicular nonunion after an operation.
Bony Callus ; Clavicle ; Ribs ; Scoliosis ; Thoracic Outlet Syndrome*

PURPOSE: The management of the patella in total knee arthroplasty is still controversy. The purpose of this study was to evaluate clinical and radiological results after total knee arthroplasty without patellar resurfacing. MATERIALS AND METHODS: We retrospective evaluated the nonresurfaced patella in 50 Knees(45 patients) at an average of 65.5 months after total knee arthroplasty(Duracon (R), Howmedica, Rutherford, NJ). Patients were diagnosed as osteoarthritis in 45 and rheumatoid arthritis in 3 and the others were osteonecrosis and evaluated using the knee society knee score, functional knee score and modified patellar score. RESULTS: The mean preoperative knee society knee score in osteoarthritis and rheumatoid arthritis were 58.2 and 36.7 points, and functional score were 35.8 and 34 points. The mean postoperative knee society knee score in osteoarthritis and rheumatoid arthritis were 94.5 and 91.2 points, and functional score were 73.2 and 81 points and the mean modified patellar score was 28.5 points, and 26 cases(52%) were excellent(30-35 points), 18 cases(36%) were good(25-29 points) and 6 cases(12%) were fair(20-24 points). There were no patella-associated complications and in 8 cases(16%) of anterior knee pain, which resolved by a postoperative 4.1 months with conservative treatment. CONCLUSION: Total knee arthroplasty with patelloplasty, without patellar resurfacing , provided satisfactory results without significant problems, and can avoid the patellar complications. But long term radiological and clinical follow-up is recommended.
Arthritis, Rheumatoid ; Arthroplasty* ; Follow-Up Studies ; Humans ; Knee* ; Osteoarthritis ; Osteonecrosis ; Patella ; Retrospective Studies

Postoperative chylothorax is a rare but serious complication of thoracic surgical procedures. We report two cases of chylothorax after lobectomy and mediastinal lymph node dissection for lung cancer. The patients were successfully treated with subcutaneous octreotide injection as an adjunct to conservative treatment.
Chylothorax* ; Drug Therapy ; Humans ; Lung Neoplasms* ; Lung* ; Lymph Node Excision ; Octreotide* ; Thoracic Surgical Procedures

BACKGROUND: Advanced age in Esophagectomy increases the risk of postoperative morbidity and mortality. However, the recent development of operative technique and perioperative care might have decreased the postoperative morbidity and mortality after esophagectomy. MATERIAL NAD METHOD: From March 2001 to July 2004, 174 patients underwent esophageal resection for esophageal cancer in the Center for Lung Cancer, National Cancer Center. The patients were divided into two groups : group 1 consisted of 27 patients aged 70 years or more, and group 2 consisted of 147 patients under 70 years of age. The two groups were compared according to preoperative risk factors, postoperative morbidity, operative mortality and survival. RESULT: The mean age was 63.4. There were 159 men. On histopathological examination, 93.1% had squamous cell carcinoma. On the locations, 78.7% were in mid and lower esophagus. Curative resections for esophageal cancer were possible in 162 (93.1%) patients. Mean hospital stay was 19.4 days with out difference between the groups. The overall postoperative morbidity were occurred in 61 patients (35.1%). The most frequent morbidity was pulmonary complication in 30 (17.2%). Preoperative incidence of hypertension, cardiac and pulmonary dysfunction were more common in Group I. However, there was no difference in overall postoperative morbidity, operative mortality and survival rate between the two groups. CONCLUSION: Esophagectomy for esophageal cancer could be carried out safely in patients over 70 years of age with satisfactory short-term results. Advanced age is no longer a risk factor for esophagectomy.
Incidence ; Mortality ; Risk Factors ; Lung Neoplasms ; Esophageal Neoplasms

PURPOSE: The purpose of this study was to identify the effect postoperative pulmonary complications (PPCs) in patients with non-small cell lung cancer undergoing pulmonary resection on survival. MATERIALS AND METHODS: The study involved a retrospective review of 635 patients over a 4-year period who had undergone curative lung resection for non-small cell lung cancer. The patient group included 504 (79.4%) males, and the overall mean age was 61.3 years. Patients were classified as those who had experienced PPCs (PPCs group, n=105, 16.5% of all patients) or those who had not (no PPCs group, n=530 patients). RESULTS: The surgical procedures performed were 101 (15.9%) pneumonectomies, 505 (79.5%) lobectomies and 29 (4.6%) lesser resections. Cancer types comprised 330 (52.0%) squamous cell carcinomas, 255 (40.2%) adenocarcinomas and 50 (7.8%) others. Overall survival 3 years after surgery was 68.2% in the no PPCs group and 38.8% in the PPCs group (p<0.0001). Regardless of tumor staging, overall survival differed significantly between the PPCs and no PPCs groups, while disese-free survival did not. Seventy-six patients (14.9%) in the no PPCs group and 24 patients (27.3%) in the PPCs group died during the follow up period. The primary cause of death was the recurrence of the primary lung cancer in both groups (68 patients in the no PPCs and 14 in the PPCs). The second most frequent cause of deaths was respiratory failure in the PPCs group (9 patients : 10.2%). Respiratory failure was less observed in the no PPCs group. In contrast, the incidence of respiratory failure leading to death constantly increased in the PPCs group. CONCLUSION: Patients who had postoperative pulmonary complications have taken the risk of poor survival. We emphasize on the fact that patients who experienced postoperative pulmonary complications need careful and frequent shortterm follow-up to improve overall survival
Adenocarcinoma ; Carcinoma, Non-Small-Cell Lung* ; Carcinoma, Squamous Cell ; Cause of Death ; Follow-Up Studies ; Humans ; Incidence ; Lung ; Lung Neoplasms ; Male ; Neoplasm Staging ; Pneumonectomy ; Recurrence ; Respiratory Insufficiency ; Retrospective Studies

BACKGROUND: Although the most common pathogen of liver abscess was Escherichia coli in the past, there has been an increasing number of reports on liver abscess caused by Klebsiella pneumoniae, especially in Asia and its more frequent occurrence in diabetes mellitus. Our study was to clarify the different clinical characteristics and prognostic factors of K. pneumoniae and non-K. pneumoniae liver abscess in patients with or without diabetes. MATERIALS AND METHODS: We reviewed medical records of pyogenic liver abscess diagnosed by defined criteria at 7 different tertiary care hospitals in Seoul and Gyeonggi Province from January 2000 to December 2003 retrospectively. RESULTS: Of the 248 cases, 86 cases (34.7%) of patients were diabetic. Cryptogenic cause (73.4%) was the most frequent portal of entry in liver abscess and 58 cases (23.4%) were the secondary following biliary disease. There were no differences in portal of entry between DM group and non- DM group. The most common organism was K. pneumoniae (70.2%) followed by E. coli (11.5%) and alpha-hemolytic streptococcus (5.2%). There were no significant differences in causative organism of liver abscess between DM group and non-DM group as K. pneumoniae was dominant pathogen [76.6% in DM group vs 66.2% in non-DM group (P=0.11)]. The metastatic complication occurred in 15 cases (8.6%) and found more frequently in DM group (P=0.042). All of the metastatic abscesses were found in liver abscess caused by K. pneumoniae (P=0.007). Ten patients died and the overall mortality rate was 4.1%. The factors associated with mortality were level of serum creatinine, past history of intra-abdominal surgery and underlying biliary malignancy. CONCLUSION: The most commom pathogen of the pyogenic liver abscess is K. pneumoniae and the metastatic complications are usually found in liver abscess caused by K. pneumoniae, especially more frequently in patients with diabetes than in patients without diabetes.
Abscess ; Asia ; Creatinine ; Diabetes Mellitus* ; Escherichia coli ; Gyeonggi-do ; Humans ; Klebsiella pneumoniae* ; Klebsiella* ; Liver Abscess ; Liver Abscess, Pyogenic* ; Medical Records ; Mortality ; Pneumonia* ; Prognosis* ; Retrospective Studies ; Seoul ; Streptococcus ; Tertiary Healthcare

BACKGROUND: Although the most common pathogen of liver abscess was Escherichia coli in the past, there has been an increasing number of reports on liver abscess caused by Klebsiella pneumoniae, especially in Asia and its more frequent occurrence in diabetes mellitus. Our study was to clarify the different clinical characteristics and prognostic factors of K. pneumoniae and non-K. pneumoniae liver abscess in patients with or without diabetes. MATERIALS AND METHODS: We reviewed medical records of pyogenic liver abscess diagnosed by defined criteria at 7 different tertiary care hospitals in Seoul and Gyeonggi Province from January 2000 to December 2003 retrospectively. RESULTS: Of the 248 cases, 86 cases (34.7%) of patients were diabetic. Cryptogenic cause (73.4%) was the most frequent portal of entry in liver abscess and 58 cases (23.4%) were the secondary following biliary disease. There were no differences in portal of entry between DM group and non- DM group. The most common organism was K. pneumoniae (70.2%) followed by E. coli (11.5%) and alpha-hemolytic streptococcus (5.2%). There were no significant differences in causative organism of liver abscess between DM group and non-DM group as K. pneumoniae was dominant pathogen [76.6% in DM group vs 66.2% in non-DM group (P=0.11)]. The metastatic complication occurred in 15 cases (8.6%) and found more frequently in DM group (P=0.042). All of the metastatic abscesses were found in liver abscess caused by K. pneumoniae (P=0.007). Ten patients died and the overall mortality rate was 4.1%. The factors associated with mortality were level of serum creatinine, past history of intra-abdominal surgery and underlying biliary malignancy. CONCLUSION: The most commom pathogen of the pyogenic liver abscess is K. pneumoniae and the metastatic complications are usually found in liver abscess caused by K. pneumoniae, especially more frequently in patients with diabetes than in patients without diabetes.
Abscess ; Asia ; Creatinine ; Diabetes Mellitus* ; Escherichia coli ; Gyeonggi-do ; Humans ; Klebsiella pneumoniae* ; Klebsiella* ; Liver Abscess ; Liver Abscess, Pyogenic* ; Medical Records ; Mortality ; Pneumonia* ; Prognosis* ; Retrospective Studies ; Seoul ; Streptococcus ; Tertiary Healthcare