The present study is concerned with angiographic findings of bone tumors in patients who have been admitted to Severance Hospital from April 1968 to March 1971. Angiography of peripheral tumors is a valuabIe procedure in that it provides important information concerning the presence or absence of a tumor, defines its size and extent, and gives indication of malignancy. Angiography as an additional aid in the diagnosis of malignant bone lesions was first presented by dos Santos, Lamas and Caldos (1931). Begg (1955) stated that a normal angiogram of a limb shows that the branches of the main artery follow a slightly curved and undulating course, and that their calibre slowly and progressively decreases. None of these vessels are seen to reach the periosteum, nor is the nutrient artery ever visible. dos Santos (1931) proposed certain angiographic criteria of malignancy, notably the presence of numerous irregular vessels at the transit of the contrast medium from the arteries to the veins. Margulis(1964)stated a large number of malignant neoplasms are highly vascular and present chaotic patterns. Their vessels have irregular lumina and arteriovenous communications are present within them. Areas of intense contrast staining occupy parts of or the entire tumor. This appearance, frequently described, has been assumed to be characteristic of and uniformly encountered in malignant tumors. Angiographies in the present study include 6 cases of Osteogenic sarcoma, 4 cases of Chondrosarcoma, 2 cases of Giant cell tumor, 1 case of Liposarcoma, 1 case of Kaposis sarcoma, 1 case of Hemangioma, 1 case of Metastatic bone tumor, 1 case of Fibrous dysplasia and 1 case of Neurofibromatosis. Angiography was performed 13 times under local and 5 times under the general anesthesis. 20 to 30cc of 50 per cent Hypaque was utilized for examination. Angiographic findings are as follows: 1. HypervascuIarity is seen in osteogenic sarcoma, giant cell tumor, hemangioma and metastatic bone tumor. But neurofibromatosis and fibrous dysplasia are avascular. 2. Irregularity of the vascular net work seems characteristic in osteogenic sarcoma, hemangioma, and metastatic bone tumor. 3. Blood pools are seen prominently in osteogenic sarcoma, giant cell tumor, hemangioma and metastatic bone tumor. but no blood pools in neurofibromatosis and fibrous dysplasia. 4. Arteriovenous shunt is seen in osteogenic sarcoma, chondrosarcoma, hemangioma and metastatic bone tumor. But there is no A-V shunt in giant cell tumor, liposarcoma, Kaposis sarcoma, neurofibromatosis and fibrous dysplasia. 5. Retention of contrast medium is seen prominently in osteogenic sarcoma and hemangioma. But no retention of contrast medium is noted in liposarcoma, neurofibromatosis and fibrous dysplasia. While I do not regard arteriography as a necessary procedure for the differantial diagnosis of all presumptive bone neoplasms, it is indeed valuable in selected cases, in differential diagnosis of bone tumors and in the demonstration of the vascularity and extent of extraosseous soft tissue masses and it can be helpful in selecting an appropriate biopsy site. By indicating the size ar,d vascularity of a lesion and its major blood supply, it may influence the surgical approach.
Angiography ; Arteries ; Biopsy ; Bone Neoplasms ; Chondrosarcoma ; Diagnosis ; Diagnosis, Differential ; Diatrizoate ; Extremities ; Giant Cell Tumors ; Hemangioma ; Humans ; Liposarcoma ; Neurofibromatoses ; Osteosarcoma ; Periosteum ; Sarcoma, Kaposi ; Veins

Twenty-two cases of non-tuberculous spinale pidural abscess treated at the Dept. of Neurosurgery, Kyungpuk University Hospital during the past 7 years from 1962 to 1969 were observed clinically. The results were summarized as follows: 1. The ratio between male and female was 2; 1. The peak age incidence of these cases was between 40 and 50 years old with 36% of patients and between 10 and 20 years old with 27% of patients falling into this range. 2. The most important source of infection was the furuncle or abscesses of the skin, which was responsible for 50% of total known cases. The most frequent site of infection was thoracolumber area, which was responsible for 50% of total cases. Among others, thoracic (32%) and lumbar (18%) areas were included. Bacterial culture was performed in 14 cases and staphylococcus was isolated in 11 cases. 3. As for clinical symptoms 12 cases revealed back pain, there showed fever, root pain and headache in some cases. Paraplegia or paraparesis observed in 19 cases, sphincter disturbance in 18 cases, sensory deficits in 17 cases, back tenderness and stiff neck were included in these groups. Pyogenic pus was aspirated in 3 cases through lumbar puncture from the epidural space. Manometric studies during the lumber puncture revealed a partial or complete blockage in 13 cases. The CSF analysis showed an increase of protein in 15 cases and an increase of cell count in 12 cases. 4. The operative findings were classified in three types. The type I, which was composed of pus only, was 4%, The type Ii of pus and granulation tissue was 50% and the type II of granulation tissue and adhesion was 36%. The postoperative prognosis has revealed to be excellent in 5 cases, good recovery in 8 cases and unimprovement of neurological deficits in 6 cases. Three cases succumbed to uncontrollable sepsis and pneumonia.
Abscess ; Back Pain ; Cell Count ; Epidural Abscess* ; Epidural Space ; Female ; Fever ; Furunculosis ; Granulation Tissue ; Headache ; Humans ; Incidence ; Male ; Middle Aged ; Neck ; Neurosurgery ; Paraparesis ; Paraplegia ; Pneumonia ; Prognosis ; Punctures ; Sepsis ; Skin ; Spinal Puncture ; Staphylococcus ; Suppuration ; Young Adult

The general intensive care unit of Presbyterian Medical Centar was opened in 1965 with 3 beds and expanded to 17 heds in 1981. Generally, the type of I.C.U. is multidisciplinary and intensive care often means a combination of recovery room service and intensive therapy. Here, we have analyzed clinically 4, 986 LC.U. patients admitted between Jan. 1986 and Dec. 1990. to obtain a better guide and management in the I.C.U.. The results were as follows I) Total number of patients for 5 years was 4,986; 1,071 patients in 1986, 1,102 patients in 1987, 1,012 patients in 1988, 952 patients in 1989, 849 patients in 1990. The ratio of male to female patients was almost 2: 1. 2) Total admission days in the I.C.U. was 26,892 days and average patient stay being 5.5 days. The average age for 5 years was 50.9 year-old-age. 3) The majority of the patients(3,526 cases, 70%) stayed in the I.C.U. less than 5 days The number of patients staying more than 9 days increased from 127 cases(12%) in 1986 to 155 cases (18%) in 1990 4) The group representing the highest number of patients admitted was in the 50 to 59 year-old-age group. About 60% of the patients admitted were in the 40 to 69 year-old-age groups and the highest mortality rate occurred in the 70 to 79 year-old-age group(24.4%). 5) The number of the patients admitted to the department of internal medicine, which was the highest among all departments, was 3,564 caaes. Mortality rate was highest in the department of pediatric. 6) During 5 years, overall mortality rate was 21.9%(1,091 cases) inclusive of the hopeless-dis-charged patients. 7) Liver cirrhosis & variceal rupture of esophagus was the commonest disease. Mortality rate WS8 highest in leukemia(50%) & lymyhoma(50%) and lowest in acute renal failure(0%). 8) After putting into operation of nation-wide medical. insurance scheme, average patient stay and average age were increased. From the above results, it can be concluded that average admission days, average age and patients staying more than 9 days in the I.C.U. increased annually.
Esophagus ; Female ; Humans ; Insurance ; Intensive Care Units* ; Critical Care* ; Internal Medicine ; Liver Cirrhosis ; Male ; Mortality ; Protestantism ; Recovery Room ; Rupture

In order to establish the predicted normal values of the systolic time intervals the duration of the systolic time intervals measured from simultaneous recordings of the electrocardiogram, the phonocardiogram and the carotid pulse tracing. The subjects studied were 160 healthy males and 160 females. The mean ages of males and females were 29 and 31 years old, respectively. The transformation period was not closely related to heart rate, and its mean values for males and females were 58 and 56 msec., respectively, and the mean for males and females combined was 57 msec. The remainder of the systolic time intervals, however, showed a significant linear and inverse relation to heart rate. Thus, based upon these data regression equations for the prediction of the normal values of electromechanical systole, left ventricular ejection time, mechinical systole, precjection period andisovolumiccontraction time for males, females, and males and females combined were obtained.
Adult ; Electrocardiography ; Female ; Heart Rate ; Humans ; Male ; Reference Values* ; Systole*

PURPOSE: Pneumonia is a serious and relatively common complication among submersion victims without out-of-hospital cardiac arrest (OHCA). The purpose of this study was to investigate the risk factors of pneumonia among adult submersion victims without OHCA. METHODS: All adult submersion victims without OHCA who visited our hospital between 2004 and 2013 were included. This study was conducted retrospectively, with collection of data by review of medical records. Among total submersion victims (310 patients), 191 patients did not suffer OHCA. We investigated the characteristics of the patients and classified them according to two groups based on the presence of pneumonia. We then compared clinical variables between the two groups. RESULTS: A total of 191 adult submersion patients without OHCA; 157 patients did not have pneumonia during their hospital stay; 34 patients had pneumonia. In respective analysis, alert mentality, pH and core temperature showed correlation with pneumonia. However, in logistic regression analysis with these 3 variables, only pH was a risk factor of pneumonia. All patients with pneumonia except one were discharged with full recovery. CONCLUSION: The risk of pneumonia among adult submersion victims without OHCA is higher when the lower pH is checked. Further studies are needed in order to evaluate the other risk factors of pneumonia for early prediction and proper management.
Adult* ; Heart Arrest ; Humans ; Hydrogen-Ion Concentration ; Immersion* ; Length of Stay ; Logistic Models ; Medical Records ; Out-of-Hospital Cardiac Arrest* ; Pneumonia* ; Respiratory Distress Syndrome, Adult ; Retrospective Studies ; Risk Factors

We report a case of primary cutaneous adenoid cystic carcinoma in a 39-year-old male patient. It was a slightly erythematous hard nodule on left chin and composed of cribriform and tubular masses of basaloid cells. Lumina formed by neoplastic cells contained mucin and hyalin, and similar constituents were located between neoplastic cell masses and adjacent dermis. Immunohistochemically, the neoplastic cells stained only focally with S-100 protein and negative with carcinoembryonic antigen(CEA). Therapy should employ wide surgical excision that extends well beyond the clinical confines of the neoplasm.
Adenoids* ; Adult ; Carcinoma, Adenoid Cystic* ; Chin ; Dermis ; Humans ; Hyalin ; Male ; Mucins ; S100 Proteins

No abstract available.
Exophthalmos* ; Neurofibromatoses*

BACKGROUND AND OBJECTIVES: Benign paroxysmal positional vertigo (BPPV) is one of the critical life events that can affect physical, emotional, and functional aspects of quality of life. Canalith repositioning procedure (CRP) provides rapid and long lasting relief of symptoms in most patients with BPPV. However, some patients express nonspecific symptoms such as anxiety or discomfort after treatment, The purpose of this study was to assess the residual symptoms after CRP in patients with BPPV using Dizziness Handicap Inventory (DHI) in a questionnaire format and to evaluate the therapeutic efficacy of CRP according to accompanying the DizzyFIX device. MATERIALS AND METHODS: We performed a prospective investigation in 135 consecutive patients with confirmed posterior semicircular canal BPPV. CRP was performed until nystagmus and vertigo disappeared. Patients were divided into three group using the DizzyFIX (group A), not using the DizzyFIX (group B) and closed observation (group C) after treatment. Then patients were asked to complete the questionnaire for Korean form DHI before treatment, 1, 2, 3, 4, and 8 week after treatment. RESULTS: There was a significant improvement in DHI scores when comparing the pre CRP and post CRP three groups (p<0.05), although emotional items showed incomplete improvement at 1 week. But at 2 week after treatment, there were statistically significant differences between group A and other groups in DHI scores specially in emotional items. CONCLUSION: Even after successful CRP, DHI scores indicated incomplete recovery and residual subjective symptoms may remain. For these patients additional follow up and management are necessary and using of the DizzyFIX will be helpful to reduce the incidence of residual dizziness especially emotional aspect.
Anxiety ; Dizziness ; Follow-Up Studies ; Humans ; Incidence ; Prospective Studies ; Quality of Life ; Surveys and Questionnaires ; Semicircular Canals ; Vertigo

BACKGROUND: Composite grafts have advantages for small nasal defect coverage. However, if the the outer skin defect and the inner skin defect have a different location, conventional composite grafts encounter considerable limitations. Therefore, we devised a 4-limbed graft to overcome this limitation by use of soft tissue transposition. METHODS: Over the course of 5 years, this auricular composite graft was used in 10 cases of reconstruction. We harvested skin and cartilage from the helix. The composite graft had 2 limbs of soft tissue to cover the nasal defect and another 2 limbs of cartilage to support nasal framework. The cartilage limbs extended 3 to 5 mm beyond the margin of the skin. The direction of each limb was modified according to defect position. RESULTS: All 10 composite grafts survived completely. All composite grafts shrank by a small percentage of their bulk. Nonetheless, the nasal framework was maintained to an acceptable extent because of the cartilage limbs. CONCLUSIONS: This technique was capable not only of covering defects in the alar and columellar area, but also of maintaining a satisfactory external appearance, because the 2 limbs of cartilage included in the graft strengthened the nasal framework and provided modest support to the nostril margin. The 2 limbs of soft tissue covered the defect area. Our 4-limbed auricular chondrocutaneous composite graft is reliable option for the reconstruction of alar and columellar defects in a single-stage procedure.
Cartilage ; Extremities* ; Reconstructive Surgical Procedures ; Skin ; Transplants*

PURPOSE: Due to an increased interest in health, there have been many types of marathon races for athletes and the general population. Marathon is an extremely difficult sport, therefore, many running injuries can occur. In this study, we aimed at characterization of injuries and clinical courses resulting from marathon induced heat stroke. Based on our findings, we provide suggestions for proper management of patients with marathon induced heat stroke. METHODS: We performed a retrospective study of 24 patients who visited the emergency department (ED) at Yeouido St. Mary's hospital between January 2000 and August 2011 with symptoms of heat stroke resulting from participation in a marathon race. We reviewed the medical records, which showed clinical presentation and laboratory findings. RESULTS: Of the 24 patients, 20(83.3%) were men. Their average age was 38.1+/-8.4 years old and their average initial rectal temperature was 39.9+/-1.3degrees C. Seventeen (70.8%) patients came to the ED complaining of syncope and seven(29.2%) came because of mental change. In follow-up laboratory tests, ten patients showed an increased level of serum Creatine phosphokinase (CPK) to over 1,000 IU/L, six showed serum Aspartate aminotransferase (AST)/Alanine aminotransferase (ALT) to over 300 IU/L, four showed serum creatinine to over 2.0 mg/dL, and two showed an increase in serum troponin-I and MB fraction of creatine kinase. Results of initial laboratory tests showed normal AST/ALT levels, however, they started to rise between 12 to 24 hours, and reached the highest record after 2~3 days of hospitalization. CONCLUSION: Marathon induced heat stroke can cause various complications, such as rhabdomyolysis, acute hepatic injury, acute renal failure, and metabolic acidosis. Therefore, we recommend follow-up and observation for patients with marathon induced heat stroke.
Acidosis ; Acute Kidney Injury ; Aspartate Aminotransferases ; Athletes ; Continental Population Groups ; Creatine Kinase ; Creatinine ; Emergencies ; Follow-Up Studies ; Heat Stroke ; Hot Temperature ; Humans ; Male ; Medical Records ; Porphyrins ; Retrospective Studies ; Rhabdomyolysis ; Running ; Sports ; Syncope ; Troponin I