Clinical analysis of fracture of femral shaft in 73 cases treated at the 17 Army Hospital during the period from May 1965 to July 1968 is presented. 1) All the patient were males and in the 3rd decade of life. 2) Sites of fracture were 28 in midshaft, 23 in lower one-third, 22 in upper one-third, and 29 cases: had open fracture. 3) 32 cses(43.8%) were injured by traffic accident which is the most common cause in this series. 4) Conservative treatmet was given in 30 cases, plate fixation in 15 cases, and Kuentscher type of I.M. nailing in 28 cases. 5) Criteria evaluating the results were; knee joint motion, length & alignment of the femur, and pain during weight bearing. 6) Severely comminuted fracture tends to deserve conservative measure only and sites of fracture contraindicated for I.M. nailing were best treated by plate or screw fixation. 7) A comparison has been made between the functional results treated by conservative method and open reduction (plate & screw fixation and I.M. Kuentscher nailing). Excellent or good results were obtained, by conservative (30 cases), plate and screw fixation. (15 cases), and I.M. Kuentscher nailing(28cases), in 46.7%, 60%, and 60.7% respectively. Functional results were slightly better in I.M. nailing than the other two methods. 8) Time of complete healing by solid bone union was; 6.5 months in (30 cases of) conservative treatment, 6 months in (10 cases of) plate and screw fixation, and 5.5 months in (22 cases of) I.M. Kuentscher nailing. 9) Postoperative infection rate,severe enough to interfere healing) was 6.6% (only one case) of plate group and 3.6%(only one case) of I.M. nailing group.
Accidents, Traffic ; Adult ; Femur ; Fractures, Comminuted ; Fractures, Open ; Hospitals, Military ; Humans ; Knee Joint ; Male ; Methods ; Weight-Bearing

Eruptive vellus hair cysts and steatocystoma multiplex have clinical similarities in terms of age of onset, location and appeararice of the lesions, but histopathologic feitures are distinctively differen-tiated. We present herein a 37-year-old woman with eruptive vellus hair cyst and steatocystoma multiplex as well. The histopathologic sections from 2 different lesions showed features of both eruptive vellus hair cyst with sebaceous gland in and near the cyst wall, and steatocy toma multiplex with rudimentary hair follicle near the cyst wall. This case may support the premie that eruptive vellus hair cyst and steatocystoma multiplex have a common developmental origin.
Adult ; Age of Onset ; Female ; Hair Follicle ; Hair* ; Humans ; Sebaceous Glands ; Steatocystoma Multiplex*

The clinical study was performed to 28 patients with the pericardiac effusion who were admitted in Busan university Hospital and Paik Hospital, In-Je Medical College, Busan, korea during March 1976 and July 1981. The results were as following; 1) 12 cases(42.9%) of total 28 pericardiac effusion occured in 3rd decade, 8(28.5%) in 2nd decade and 5 cases(17.9%) in 4th decade. Sex distribution showed male to female 2.5:1. 2) With etiological distribution there were 15 cases(53.6%) tuberculous, 5(17.9%) nonspecific, 3(10.7%) malignant, 2(7.1%) pyogenic, 2 traumatic and 1(3.6%) rheumatic. 3) On admission 28 cases(100%) complained of dyspnea, 24(85.7%) distant heart sound, 20(71.4%) each engorged jugular vein and edema, 18(64.3%) each cough and abdominal fullness, 17(60.7%) each sputum and chest discomfort and pain, 12(42.9%) fever, 11(39.1%) orthopnea, 10(35.7%) chilling, 7(25%) oliguria, 4(14.6%) palpitation and 3(17.2%) headache. Increased cardiac dullness was observed in 26 cases(71.4%), hepatomegaly 18(64.3%), pulmonary rales 17(60.7%), ascites 13(46.1%), fever 12(42.9%), pericardiac friction rub 10(35.7%), splenomegaly 7(25%), paradoxical pulse 6(21.4%) and jaundice 2(7.1%). 4) On amission SGOT and SGPT level was increased each in 15(53.6%) and 13(46.7%), TTT and CCF abnormal in 10(35.7%), and 8(28.5%), serum NPN, BUN, creatinine increased in each 10(35.7%), 11(39.1%), 8(28.5%), WBC increased in 6(21.4%), RBC decreased in 8(28.5%) and ESR increased in 16(57.1%). 5) Characteristics of pericardiac effusion showed hemorrhagic 17(60.7%), serosangeous 6(21.4%), sangeous 3(17.2%) and pyogenic 2 cases(7.1%). 6) The ECG on admission revealed low voltage in 25(89.1%), depressed ST segment in 13(46.1%) and inverted T wave in 12(42.9%). 7) Chest X-ray showing cardiomegaly 28(100%), pleural effusion in 20(71.4%), and pulmonary congestion in 16(57.1%). 8) The m mode and 2-D Echocardiogram showed echo free space in 28 cases and after pericardiocentesis the space was reduced or disappeared. 9) 19 cases of 28(67.5%) were improved clinically, while 5 cases(17.9%) were not improved and 4 cases(14.6%) died.
Alanine Transaminase ; Ascites ; Aspartate Aminotransferases ; Busan ; Cardiomegaly ; Cough ; Creatinine ; Dyspnea ; Edema ; Electrocardiography ; Estrogens, Conjugated (USP) ; Female ; Fever ; Friction ; Headache ; Heart Sounds ; Hepatomegaly ; Humans ; Jaundice ; Jugular Veins ; Korea ; Male ; Oliguria ; Pericardiocentesis ; Pleural Effusion ; Respiratory Sounds ; Sex Distribution ; Splenomegaly ; Sputum ; Thorax

Perifollicular fibromas are very undsual adnexal tumor of the skin. Clinically, they are small firm akin colored or pinkish papules and usually located on the face and neck. We report a case of perifollicular fibroma which occurred in a 30-year-old woman, who had asymptomatic multiple small skin colored papules on the right side of her face for about 20 years. On physical examination, the papules were ferm and non-tender. The biopsy specimen demonstrated concentric proliferation of fibrous tissue surrounding hair follicles ad the collagen fibers within concentric fibrous sheaths surrounding hair follicles stained green with Masson's trichrome stain, which were quite typical for perifollicular fibroma. Because we could not find any epithelial proliferation in the serial sections, fibrofolliculoma could be ruled out. The skin lesions were removed by electrodesiccation and followed up for 5 months without recurrence.
Adult ; Biopsy ; Collagen ; Female ; Fibroma* ; Hair Follicle ; Humans ; Neck ; Physical Examination ; Recurrence ; Skin

Hypergammaglobulinemic purpura of Waldenstrom is a distinct syndrome consisting of recurrent episodes of purpura, elevated serum r-globulins, elevated erythrocyteed rnentation rate, and mild anemia. This disease has been divided into the prirnary type without an uncerlying disease, and the secondary type with a known underlying disease. We diagnosed a hypergammaglobulinemic purpura of Waldenstram in a 53-year-old woman who presented sudden onset of showers of purpuric macules and petechiae of 24 hours duration involving her lower extremities with a 10-rnonth history. She showed characteristic laboratory findings consistent with those of hypergammiglobulnemic purpura of Waldenstrorri and also showed positive results of antinuclear antibody and rheumatoid factor. We tried to find out if there we any associated underlying disases such as systemic lupus erythematosus or Sjogren synirorne through various tests but faile it find any. We concluded she showed a primary type of hypergarnmhglobulinemic purpura of Waldcnstrorn.
Anemia ; Antibodies, Antinuclear ; Erythrocytes ; Female ; Humans ; Lower Extremity ; Lupus Erythematosus, Systemic ; Middle Aged ; Purpura ; Purpura, Hyperglobulinemic* ; Rheumatoid Factor

BACKGROUND: It is well-known that the giant congenital nevi prcgress to malignant, melanama more frequently than other benign melanocytic nevi but to date the laor tory methods for early detection of such progression were not avsilable. The proliferating cell uncleai antigen(PCNA) staining has been regsrded as an useful marker in determining prognosis of some maignant diseases. OBJECTIVE: The PCNA taining was performed as a predictive value of malignant transformation from benign meanocytic skin lesions. We investigated the differcnces between malignant melanoma and the benign lesions. MATERIAL AND METHODS: Immunohistochemical study was employee using anti-PCNA, anti-S-100, and anti-CD45RO antibody in 6 giant congenital nevi, 8 small and medium sized congenital nevi, 10 acquired nevi, and 10 malignant meanomas. Only cells positive for both PCNA and S-100, and negative for CD45RO on the serial sections were identified as melanocyts. RESULTS: The number of PCNA-posit,ive cells per 1000 melanocy,es averaged 6.0+7.5 in giant, congenital nevi, 2.9+1,9 in small and medium sized congenital novi, 3.1+2.7 in acquired nevi, and 61.5+ 39.4 in malignant, melanomas. Malignant melanomas showed onger intensity of PCNA staining than the other melanocytir nevi. CONCLUSION: There was not significant difference of the numter of PCNA-positive cells among the groups of congenital neviind PCNA staining can't be used in prditive measure of malignant. progression and studying mechansm of malignancy in giant congenital nevi. But, PCNA staining is considered as an useful method in differentiat,ing malignant melanoma from mllanocytic nevi.
Melanoma ; Nevus ; Nevus, Pigmented ; Prognosis ; Proliferating Cell Nuclear Antigen* ; Skin*

Transitional cell carcinoma of the bladder, adenocarcinoma of the prostate, and renal cell carcinoma are common urogenital cancers, but a synchronous triple urogenital cancer is extremely rare. The standard treatment for the triple urogenital cancer has not yet been established. The strategy of management should be determined based on the stage and grade of the most life-threatening cancer. We report a case of synchronous 4 tumors in a 66-year old male, which consisted of a renal cell carcinoma of the right kidney, a transitional cell carcinoma of the bladder, a adenocarcinoma of the prostate, and a hamartoma of the lung. Radical cystectomy with ileal conduit, partial nephrectomy, and adjuvant chemotherapy with Gemcitabin and Cisplatin was performed. At a 16-month follow-up, metastasis to the rectum was found, and rectal obstruction was present in the patient. After transverse colostomy, chemotherapy and radiation therapy was initiated.
Adenocarcinoma ; Aged ; Carcinoma, Renal Cell ; Carcinoma, Transitional Cell ; Chemotherapy, Adjuvant ; Cisplatin ; Colostomy ; Cystectomy ; Drug Therapy ; Follow-Up Studies ; Hamartoma ; Humans ; Kidney* ; Lung* ; Male ; Neoplasm Metastasis ; Nephrectomy ; Prostate* ; Rectum ; Synchrotrons ; Urinary Bladder* ; Urinary Diversion ; Urogenital Neoplasms

Endotheline-1 (ET-1) is a potent vasoconstrictor peptide with 21 amino acid residues. ET-1 is thought to have a key role in vasoconstriction, and cardiac, renal, and endocrine actions of the peptide. Creatine Kinase(CK), also referred to as ATP-creatine-N-phosphotransferase, consists of either the B or M type. CK is found almost exclusively in muscle(MM), myocardium(MB), and brain(BB). It is to be an almost specific index of injury of myocardium and brain in hypoxic damage. I measured the ET-1, CK isoenzyme in neonates among asphyxia group (14 cases), as a control devide into two group. 1st group(birth weight (2500 g, n=9) and 2nd group (body weight 2500g, n=11). 1) There was no significant difference between asphyxia and control 1st, 2nd group during postnatal 24 hrs include cord blood on irET-1(p< 0.05). 2) There was significant difference between asphyxia and control 1 st, 2nd group during postnatal 24 hrs include cord blood on CK and CK and CK isoenzyme (p<0.001). 3) There was significant difference between asphyxia and control 1st, 2nd group on CK-MB and CK-BB proportion (p< 0.001). 4) There was significant difference between cord blood and postnatal 24 hrs on total CK level (P< 0.001).
Asphyxia* ; Brain ; Creatine Kinase* ; Creatine* ; Fetal Blood ; Humans ; Infant, Newborn* ; Myocardium ; Plasma* ; Vasoconstriction

While most dermal melanocytoses are congenital or have an onset in early childhood, there is an acquired group with a late onset. We describe a case of aldolescent onset, unilateral, macular dermal melanocytosis on the hand. A 16-year-old girl presented with a 10-month history of gray-bluish pigmentation on the right palm and the volar side of the right fourth finger. The light microscopic studies showed spindle-shaped dermal melanocytes. The S-100 protein staining of these cells was positive and CD68 staining was negative. Dermal melanocytosis of the macular type, as observed in our case, is very rare.
Adolescent ; Female ; Fingers ; Hand* ; Humans ; Melanocytes ; Pigmentation ; S100 Proteins

Mitral valvular orifice area is important for the evaluation of prognosis and treatment of patients with mitral valvular stenosis. Until recently, Gorlin's formula using cardiac catheterization has been utilized in the measurement of mitral valve area, but it is invasive and impractical to examine repeatedly. Recently 2-Dimensional echocardiography appeared to be a practical and useful substitute in measurement of valve area and also it is economical and has no risk to patients. In 31 patients with mitral valvular stenosis examined at the echocardiography room of Busan national University Hospital from March 1982 to March 1983, we measured the mitral valve area with 2-Dimensional echocardiography and evaluated its relationship with the left ventricular functions measured on M-mode echocardiogram. Among many parameters on M-mode measurements EF slope, excursion amplitude and the ratio of left atrial dimension to aortic root dimension were rather helpful for the assessment of severity of mitral valvular stenosis than other parameters. And each relationship with the valve area showed correlation coefficient of 0.60, 0.05 and -0.58, respectively.
Busan ; Cardiac Catheterization ; Cardiac Catheters ; Constriction, Pathologic* ; Echocardiography* ; Humans ; Mitral Valve* ; Prognosis ; Ventricular Function, Left