Chest CT is the most useful modality in the diagnosis of primary lung cancer, particularly in patients with recurrent pneumonia which are resistant to antibiotic therapy and in high risk age groups for cancer, The purpose of this examination is to assess the usefulness of CT in pneumonia types of lung cancer. The authors retrospectively analyzed 15 histologically proven cases of pneumonic type lung cancer, which had no evidence of primary lung mass, mediastinal lymphadenopathy or other metastatic lesion on piain chest radiography. On CT scan, a primary lung mass was identified in 13 patients(87%, bronchial obstruction was identified in 12 patients(80%), and metastatic foci was found in the bone(one patient), liver(one patient), and spleen(one patients). In Conclusion, CT scan is a useful method to detect the mediastinal lymphadenopathy or pulmonary mass and also should be the initial radiolographic procedure for diagnosis of lung cancer in patients with recurrent pneumonia on simple chest radiography.
Diagnosis ; Humans ; Lung Neoplasms* ; Lung* ; Lymphatic Diseases ; Methods ; Pneumonia* ; Radiography ; Retrospective Studies ; Thorax ; Tomography, X-Ray Computed

From Mar. 1984 to Mar. 1994, we carried out 18 revision operations in patients who received Girdlestone operation due to the infection of hip was 7 cases, tuberculosis of hip was 3 cases, deep infections after implant insertion of hip were 5 cases, and pyogenic sequela was 1 case. The mean conversion period was 27 months. The leg length discrepancy, range of motion of hip, and Trendelenberg gait were examined before and after conversion to a total hip arthroplasty. The last functional state was evaluated and radiological examination was performed. In summary and Conclusion; 1. The time of performing revision hip arthroplasty was assessed by clinical, radiologic and laboratory finding, and the average time of conversion to total hip arthroplasty was 7.6 months after Girdlestone operation. 2. There was no case of recurrence of infection after revision operations. 3. At last follow-up after revision hip arthroplasty, the mean Harris Hip Score was 87.2(69.6–92.2) point. 4. Six patients had no pain, 8 patients had mild pain, and 2 patients had moderate pain. Nine patients were able to walk without ambulatory aids and 7 patients needed crutch or cane for walking. 5. At the time of revision hip arthroplasty, the average shortening of the resected limb was 4.2cm(1.6–7.3cm), and after revision operation, the average shortening was reduced to 1.2cm(0.8–2.2cm) 6. The technical difficulties, such as increased bleeding, bone deficiency, scar tissue formation, and limb shortening were encountered in all cases. 7. The peroneal nerve injury was developed in one patient who had conversion hip arthroplasty at 13 months after Girdlestone operation.
Arthroplasty ; Arthroplasty, Replacement, Hip ; Canes ; Cicatrix ; Extremities ; Follow-Up Studies ; Gait ; Hemorrhage ; Hip ; Humans ; Leg ; Peroneal Nerve ; Range of Motion, Articular ; Recurrence ; Tuberculosis ; Walking

Castleman's disease(Giant lymph node hyperplasia) is a pathologic entity of unknown etilogy, as attested to bythe number of names it has received, lymphoid hamartoma, angiomatous hamartoma, and giant lymph node, etc.Although the mediastinum is its most common location, it also occures in other areas of the body, usually wherelymph nodes are normally found. Authors have been experienced 2 cases of histologically porven Castleman's diseaseduring recent 3 years in Kyung Hee University Hospital, and present its radiological and pathological findings asmediastinal mass.
Hamartoma ; Lymph Nodes ; Mediastinum

No abstract available.
Female ; Humans ; Pregnancy ; Pregnancy Trimester, Second* ; Pregnancy*

OBJECTIVE: The purpose of this article is to report mixed germ cell tumor, which revealed changes compatible with early transformation of dysgerminoma to endodermal sinus tumor(EST) through histogenetic considerations and immunohistochemical stains. METHODS: Ovarian germ cell tumors were reviewed from files of Dept. Ob/Gyn. Seoul Paik Hospital fiom 1992.1 to 1996.12. Total of 5 cases include 4 pure dysgerminoma and 1 mixed germ cell tumars. All tissues were fixed in 10% neutral buffered formalin and embedded in paraffin and reviewed by two pathologists with immunohistochemical staining for cytokeratin, vimentin, AFP, PCNA, p53 & bc1-2. RESULTS: Grossly, the areas of transformation were located at the middle of the mixed tumor. The outer layer of the tumor mass was filled with typical pure dysgerminoma. They were characterised as the presence of microcysts and small glandular structures in hematoxylin-eosin(H-E) stains with positive stain for vimentin, except the tissue of the EST. The cells in the intermediate layer were characterised as the mixed form of dysgerminomatous and EST structures in H-E stains. AFP in the dysgerminomatous cells in intermediate layer and EST were stained, but not in outer layer. CONCLUSION: Dysgerminoma may possess the ability to transform to EST. There might be intermediate stage between dysgerminoma and EST, and Immunohistochemical staining for AFP, cytokeratin, vimentin, PCNA also can be used for prognosis of germ cell tumor.
Coloring Agents ; Dysgerminoma* ; Endoderm ; Endodermal Sinus Tumor* ; Formaldehyde ; Germ Cells ; Keratins ; Neoplasms, Germ Cell and Embryonal ; Paraffin ; Prognosis ; Proliferating Cell Nuclear Antigen ; Seoul ; Vimentin ; Yolk Sac*

Reconstruction of soft tissue dejects on the lower leg and foot remains a difficult challenge for surgeons. If the deject was large and complicated by bone defects, an excellent result could be obtained with free tissue transfer. In case of no bony problem, no major infection and relatively small defect, a local flap is more Convenient and economic than free tissue transfer because of its simple, one-stage and reliable operation. The vascularization of the subcutaneous tissue reveals the predominance of the vascular network in this layer with regard to the dermal or fascial plane. The dermal vascular network at the donor site is sufficient to let the skin survive without its underlying subcutaneous vascular support. Distally based adipofascial flaps, nourished by the lower perforator originating from the major vessel as link pattern were. used successfully for reconstruction of the bone and/or tendon exposure of the lower leg and foot in 10 patients. Between February 1992 and December 1995, ten cases underwent this procedure to reconstruct soft tissue defect on the lower leg and foot. The average age of the patients was 50.6 years (range 5 - 73years). Follow-up was from 10 months to 38 months (mean 21 months). The average time of the operation was about 2 hours 18 minutes. The length to width ratio of adipofascial flap was 2.4 - 5.0 : 1 (mean 3.4 : 1). The advantages of this method are easy dissection, short operation, preservation of the major vascular pericles of the lower limb, skin preservation at the donor site, thus preserve the shape of the limb and minimize donor site scar, and versatility (it is supple and can adapt to every surface, and it can be grafted on the deep or the superficial side). In conclusion, this technique is an useful and alternative method for reconstruction of soft tissue defects on the lower leg and foot in selected cases.
Cicatrix ; Extremities ; Follow-Up Studies ; Foot* ; Humans ; Leg* ; Linear Energy Transfer ; Lower Extremity ; Skin ; Subcutaneous Tissue ; Tendons ; Tissue Donors ; Transplants

PURPOSE: Long-term follow-up results of concurrent bilateral or unilateral cementless hip arthroplasty were compared. MATERIALS AND METHODS: Forty eight and 49 patients with concurrent bilateral and unilateral hip artrhoplasties who had more than a 17-year follow-up time were selected. At final follow-up, mean ages were 69.1 and 66.7 years old in the bilateral and unilateral groups, respectively. Mean follow-up times were 21.5 and 22.4 years in the bilateral and unilateral groups, respectively. Clinical results were attained using Harris hip score and standardized anteroposterior and lateral view X-rays. RESULTS: The bilateral group had mean Harris scores of 44.3(standard deviation 3.78) preoperatively, and 81.2 (10.75) at final follow-up. For the unilateral group, the mean scores were 46.5(3.27) preoperatively, and 80.1 (12.05) at final follow-up. At final follow-up, an acetabular cup was securely located in 78.9% and 82.8% of the bilateral and unilateral groups, respectively, and all cases showed firm fixation of the femoral stem in both groups. Osteolysis around the cup and stem were found in 26.3% and 31.4% of the bilateral group and 16.6% and 17.1% of the unilateral group, respectively. Polyethylene wear rate was 0.17 mm/yr and 0.16 mm/yr in the unilateral and bilateral groups, respectively. Using the Kaplan-Meier method, 17-year survival rates for cup and stem were 78% and 89% in the bilateral group, respectively, and 78% and 86% in the unilateral group, respectively. CONCLUSION: In 17-year long-term follow-up, concurrent bilateral hip arthroplasty was insignificantly different clinically and radiologically from the result of unilateral hip arthroplasty.
Arthroplasty ; Follow-Up Studies ; Hip ; Humans ; Osteolysis ; Polyethylene ; Survival Rate

No abstract available.
Occupational Health*

The chondrogenic potential of free autogenous periosteal grafts for osteochondral defects was investigated at the Department of Orthopaedic Surgery, Yonsei University, Wonju College of Medicine. Five millimeter diameter of circular full-thickness defects were made in patellar groove of both femur in 64 adolescent rabbits and the rectangular periostei, prepared from the proximal tibiae, were placed over the defects of patellar groove and sutured(cambium layer, facing joint surface) and the rabbits were allowed to move actively. A serial gross and histologic examinations of neochondrogenesis were done during 8 weeks. The results were as follows. l. At 2 weeks after operation, neochondrogenesis was hardly seen either in the graft group or in the control group. The defects were partially filled with some fibrous tissue. 2. After 6 weeks of operation, all defects in the graft group(postop 6 weeks and 8 weeks) were filled with hyaline cartilage cells but only 38% (postop 6 weeks) and 44% (postop 8 weeks) of the control group were filled with hyaline cartilage cells. 3. The cartilages, formed at 6 and 8 weeks, were more mature and better than those formed at 4 weeks. 4. The newly formed hyaline cartilage of the graft group filled the defect earlier and were better than those of the control group. 5. The chondrocytes in the newly formed tissue were originated from the cambium layer of periosteal grafts. 6. Free autogenous periosteal grafts can repair a full-thickness defect in a joint surface by producing tissue that resembles articular cartilage grossly and histologically.
Adolescent ; Cambium ; Cartilage ; Cartilage, Articular ; Chondrocytes ; Femur ; Gangwon-do ; Humans ; Hyaline Cartilage ; Joints ; Rabbits ; Tibia ; Transplants

We performed 15 cases of modified Bristow procedures for recurrent anterior instability of shoulder from january, 1987 to december, 1992 and the following results were obtained. 1. The patient's age at initial dislocation varied from 15 years to 29 years of age. 2. The most common cause of the recurrent anterior instability of shoulder was sport injury(6 cases) and next were traffic accident, hanging with one hand. 3. The average loss of external rotation of shoulder after operation were 10 degrees and internal rotation were 7 degrees. 4. The post-operative complication and recurrence were not observed. 5. End results were excellent in 7 and good in 5 by Rowe's grading system. 6. Strict attention to bone block placement was mandatory and decreased the risk of screw malpo-sition.
Accidents, Traffic ; Dislocations ; Hand ; Recurrence ; Shoulder ; Sports