No abstract available.
Fractures, Malunited* ; Radius*

We rep a case of vulvar syringoma in a 32-year-old woman who had pruritus vulvae for 2 years. An examination of both the labia major revealed slightly thickened hyperpigmented or hypopigmented patches without yellow papules. A skin punch biopsy revealed characteristic histological findings of syringoma. Syringoma of the vulva is a rare disorder and is usually asymptomatic. Five cases of vulvar syringoma preriously reported in the Korean literature all had asymptomatic yellow or brown colored papules, but this case presented here was clinically considered as pruritus vulvae.
Adult ; Biopsy ; Female ; Humans ; Pruritus Vulvae* ; Pruritus* ; Skin ; Syringoma* ; Vulva

The slipped capital femoral epiphysis is characterized by a growth disturbance of the capital physi. resulting in weakening of this structure and a subsequent displacement of the femoral head on the fe moral neck. It is a rare entity in Korea and only six cases have been reported so far1-5). One of ou cases was a bilateral mild acute slips in 13 yearold boy which were treated by Hagie pinning. Th other case, a 17 year-old boy, who suffered from a moderate acute on chronic slip in his left hip an showed a typical Pistol grip deformity. He was treated by gentle closed rcduction and Knowles pi fixation with good result.
Congenital Abnormalities ; Epiphyses ; Hand Strength ; Head ; Hip ; Humans ; Korea ; Male ; Neck ; Slipped Capital Femoral Epiphyses

When the multiple myelographic defects at lumbosacral region are noted, the prudential effort for decision of appropriate area of surgical decompression would be needed. Fifty four patients who had been treated surgically for the deseases, such as HNP and spinal stenosis, from March in 1982 to Feb. In 1987 at Department of Orthopecdic Surgery, Soonchunhyang University Hospital, were analyzed in order to define the etiology, the level of the defect, indication for the operation and to assess the results of each level which had been operated. The results of the study were as follows. 1. The number of patients, which the multiple indentations were noted in the myelogrsphy, was 54 cases, 29 spinal stenosis, 15 HNP and 10 mixed types. 2. The most common defect levels in myelography were L3-4 snd L4-5, which were 19 cases (35.2%), the next levels were L4-5 and L5S1, which were 16 cases(29.6%), then L3-4, L4-5 and L5S1 were 7 cases(13%) and the other levels were 12 cases(22.2%). 3. The decision for the sppropriste operation area had not be done following to the size of the myelographic defect, but the clinical symptoms and physicsl exsminations. 4. The results were classified ss excellent or good in 79.7%, which was 80% at two levels snd 79.5% at one level. 5. The operation levels could be decressed for the reducing the spinal instability, operation time and possibility of the dangerous conditions and promotion of early restoration and, ambulation, if the severe differences between the results of one and two operation levels were not seen.
Decompression, Surgical ; Humans ; Lumbosacral Region ; Myelography ; Spinal Stenosis ; Walking

No Abstract available.
Cross Infection* ; Korea*

Broncho-gastric fistula caused by benign gastric ulcer perforation after esophagectomy is very rare. In general anesthesia of a patient with broncho-gastric fistula, in spite of hyperventilation, leakage of the anesthetic gases through fistula may make the patient hypercapneic, and positive pressure ventilation may increase the risk of the pulmanary aspiration by the regurgitation of gastric fluid by stomach distension. For that reason, in this patient, denitrogenation was performed during patient's voluntary respiration with 100% oxygen for 5 minutes, and induction was performed without positive pressure ventilation, and one lung ventilation was carried out. Hypoxemia was followed by one lung ventilation because his pulmonary function was moderate obstructive type and his lung was damaged by aspiration of gastric fluid via broncho-gastric fistula. A low level of continuous positive airway pressure (CPAP) has no significant hemodynamic effect and can maintain the patency of nonventilated lung, so hypoxemia induced by one lung ventilation may be reduced. Thus we carried out one lung ventilation with CPAP (10 cmH2O) in nonventilated lung and blocked broncho-gastric fistula with a bronchial blocker for prevention of both regurgitation of gastric fluid and leakage of anesthetic gases. One lung anesthesia was performed without any problem in this case.
Anesthesia ; Anesthesia, General* ; Anesthetics, Inhalation ; Anoxia ; Continuous Positive Airway Pressure ; Esophagectomy ; Fistula* ; Hemodynamics ; Humans ; Hyperventilation ; Lung ; One-Lung Ventilation ; Oxygen ; Positive-Pressure Respiration ; Respiration ; Stomach ; Stomach Ulcer

PURPOSE: The objective of this study was to assess the usefulness of a unilateral x-ray of the kidney, ureter and bladder (hemi-KUB), in the place of a full-KUB, in the follow-up of patients treated with extracorporeal shock wave lithotripsy (ESWL), and thereby reduce the radiation exposure for patients. MATERIALS AND METHODS: A total of 111 patients, who underwent ESWL, between March 2000 and July 2002, were enrolled onto the study. Patients with bilateral stones, or who had changed to another treatment model, were excluded. During the follow-up to the ESWL, we used the hemi-KUB method for the collimation of the radiation field. The numbers of hemi-KUBs during the treatment were recorded. The reductions in the exposure to the radiation dose, per patient, were calculated and analyzed according to the sizes and shapes of the stones. The typical doses were: for IVU (6 films), 2.5mSv; full-KUB film, 0.42mSv; and a hemi-KUB film, 0.21mSv. RESULTS: The total reduction in the doses of radiation exposure was 114.45mSv. The radiation doses, per patient, were reduced by a mean of 1.03+/-0.58mSv. The reduction in the dose of radiation exposure correlated well with the stone size (r=0.7082, p<0.05). The mean number of hemi-KUBs (mean reduction dose of radiation exposure), according to the stone size groups: these being 5-9, 10-19 and +/-20mm, were 3.82+/-1.76 (0.80+/-0.37), 6.52+/-2.10 (1.37+/-0.44) and 11.00+/-3.85 (2.31+/-0.81)mSv, respectively (p<0.05). Also, the mean number of hemi-KUBs (mean reduction dose of radiation exposure), according to the stone shapes, typed into I (less organized or lacy), IIa (spiculated), IIb (mulberry), III (round or ovoid) and IV (struvite or staghorn), were 2.77+/-0.85 (0.58+/-0.18), 4.48+/-1.86 (0.94+/-0.39), 4.83+/-1.43 (1.01+/-0.30), 7.54+/-1.36 (1.58+/-0.29) and 8.75+/-3.72 (1.84+/-0.78)mSv, respectively (p<0.05). Using the receiver operating characteristic curve, the cut-off value, of a stone size that could be used to determine the risk group whose radiation exposure exceeding 5mSv (personal permissible dose/year), was 23.52mm, but when using a full-KUB this was 7.97mm. CONCLUSIONS: The use of hemi-KUB is a simple and easy method to reduce the radiation exposure in the follow-up of an ESWL, especially in patients with stones larger than 7.97mm in size, with a round-ovoid or staghorn shape.
Follow-Up Studies* ; Humans ; Kidney* ; Lithotripsy* ; ROC Curve ; Shock* ; Ureter* ; Urinary Bladder*

Dermatofibroma with granular cells is composed mainly of spindle shaped cells mixed with in-conspicuous foamy cells that contain granular cytoplasm. We present a case of dermatofibroma with granular cells in a 36-year-old male who visited our clinic to evaluate a slow-growing nodule on the medial side of the left lawer leg. He have had the nodule for five years and sometimes felt an itching sensation. Biopsy of the nodule identified a dermal nodular tumor showing cellular spindle cell proliferation admixed with peripheral foamy histiocytes. With the immunohistochemical staining, the granular cell was positive for alpha-1-antitrypsin and CD68, and negative for S-100. A few electron-dense granules were seen in the cytoplasm on the electronmicroscopic study. These results suggested that the granular cells originated from histiocytes.
Adult ; Biopsy ; Cell Proliferation ; Cytoplasm ; Histiocytes ; Histiocytoma, Benign Fibrous* ; Humans ; Leg ; Male ; Pruritus ; Sensation

No abstract available.

During the period from 1988 to 1993, 86 cases of varicose vein in lower extremity were treated at Department of General surgery, Chonnam University Hospital. 36 outpatients were treated by compression sclerotherapy and 50 inpatients by surgery. The results were as follows ; 1) The prevalent age group were 4th and 5th decade. 2) The predisposing factors of varicose vein were profession requiring long time standing (48.8%), pregnancy (14%) and hereditary (4.7%), in order. 3) Varicose veins were located in the greater saphenous system (50%), the lesser saphenous system (46.5%) and both (3.5%). 4) The cardinal symptoms and signs were tortuosity of veins(100%), aching pain(29.1%), leg heaviness(14.0%), walking discomfort(8.1%) and leg edema(7.0%). 5) The used sclerosing agent was 5% ethanolamine oleate in compression sclerotherapy group and the operation method in surgery group was high ligation and vein stripping. 44.4% of patients treated initially by compression sclerotherapy and 80% of those treated surgically were given no further treatment. 6) The postoperative complications in surgery group were recurred or remained varicosity (5 cases), hematoma(2 cases), recurrent ulcer(1 case), wound dehiscence(1 case) and thrombophlebitis(1 case). 7) The complications in sclerotherapy group were recurred or remained varicosity(10 cases), induration and bluish discoloration(1 case).
Causality ; Ethanolamine ; Humans ; Inpatients ; Jeollanam-do ; Leg ; Ligation ; Lower Extremity* ; Oleic Acid ; Outpatients ; Postoperative Complications ; Pregnancy ; Sclerotherapy ; Varicose Veins* ; Veins ; Walking ; Wounds and Injuries