The wrist joint is exposed to trauma easily which is a small portion of human body. Because there are many structures(tendons, vessels and nerves) in the wrist, it is necessary to examine carefully and treat properly when it is damaged. We have treated 230 cases of soft tissue injuries around the wrist and the result can be summarized as follows; 1. Among the 230 cases, the male ratio was 85% and the highest incidence was in the third decade. 2. Right side injuries were more than left and flexor surface injuries were more than extensor surface. 3, The main cause of injury was glass, 149 cases(64.8%) and the next on was knife, 37 cases(16%). 4. Injuries in the night were more than daytime. 5. Injuries in the summer were more than winter.
Glass ; Human Body ; Humans ; Incidence ; Male ; Soft Tissue Injuries ; Tendons ; Wrist Joint ; Wrist

A perplexing developmental error is 46,XX congenital absence of vagina ( Mayer-Rokitan-sky-Kster-Hauser syndrome, Mullerian dysgenesis, vaginal aplasia ). The Mayer-Rokitansky-Kster-Hauser syndrome refers to the climical entity consisting of primary amenorrhea associated with congenital absence of the vagina, 46,XX karyototype, a rudimentary uterus or complete absense, normal overian function and normal ovulation, normal female breast development, body proprotion and body hair, frequent association of renal, skeletal and other cpngenital anomalies. This syndrome results from agenesis of both Mllerian ducts or from a failure of the Mllerian ducts to estavlish a proper communication with that part of the vagina from the urogenital sinus. A case of mayer-Rokitansky-Kster-Hauser syndrom was reviewed briefly.
Amenorrhea ; Breast ; Female ; Hair ; Humans ; Ovulation ; Uterus ; Vagina

PURPOSE: This study was undertaken to obtain better clinical insights and therapeutic approaches to the diverticular diseases of the colon by identifying the clinical characteristics of the right and left colonic diverticular diseases. METHODS: A retrospective analysis was made of 68 colonic diverticular patients treated between August of 1986 and July of 1997. Right colonic diverticular disease was present in 55 patients, left side disease in eight patients, and bilateral disease in five patients. According to the location of the colonic diverticular disease, various clinical parameters such as the nature of the diverticula, age and sex, diagnostic accuracy, and methods of treatment were assessed. RESULTS: The average age of 68 patients in this study was 50.94 years. Fifty two patients were male and sixteen were female. The disease was far more common in the right colon (80.9%) than the left colon (11.7%) and the right colonic diverticular disease was the most common source of confusion in diagnosis from acute appendicitis. Conservative management was tried in 30 of 35 patients above age 50 and obtained a good result without any complication. CONCLUSIONS: There has been a tendency toward increased incidence of annual colonic diverticular diseases in this study. The right colonic diverticular disease was far more common than the left side disease and the disease was more common in the male. In patients above age 50, initial conservative management is a reasonable approach, although early surgical exploration might be better in younger patients. Acute appendicitis should be ruled out before any treatment decision was made.
Appendicitis ; Colon ; Diagnosis ; Diverticulum ; Female ; Humans ; Incidence ; Male ; Retrospective Studies*

PURPOSE: This study was aimed to determine the relationship between osteopontin(OPN) and osteoclast, especially focused on whether ostecolast could produce osteopontin or not. MATERIALS AND METHODS: Osteoclasts were isolated from the giant cell tumor of proximal tibia and seeded on the 13 mm round cover slip resided in 24 multi-well plates for culture. After 2 days, osteclasts on the cover slip were fixed with cold acetone for 3 minutes and immunocytochemistry was done with rabbit osteopontin antibody. For in situ RT-PCR, osteoclasts on the cover-slips were fixed with 4% paraformaldehyde for 4 hours and were treated to pepsin. PR-PCR was done and the PCR producst were stained with anti-digoxigenin-AP. RESULTS: Osteopontins were found on the surface of the osteoclast by immunocytochemistry, and intense osteopontin mRNAs were found by in situ RT-PCR. CONCLUSION: We have identified that osteoclast could synthesize the osteopontin, and confirmed that in situ RT-PCR was a very useful method in expressing small amount of mRNA in case of mixed cell culture. Further study was needed to identify the action of the osteopontin produced by the osteoclast.
Acetone ; Cell Culture Techniques ; Giant Cell Tumors ; Immunohistochemistry ; Osteoclasts* ; Osteopontin* ; Pepsin A ; Polymerase Chain Reaction ; RNA, Messenger ; Tibia

A pathologic fracture is a fracture of a bone with preexisting structural weakness. When considering the local treatment of pathologic fractures, those resulting from disorders which cause a generalized weakness of the whole or part of the skeleton can be largely treated conservatively. And those because of localized bone destruction or weakness often require operative treatment. For ten years from 1973 to 1983, we observed and analysed 26 cases of pathologic fractures, excluding those due to osteoporosis. The results were as follows: 1. The age distribution showed an even pattern, and the male to female ratio was 58% (15 Males): 42% (11 Females). 2. The underlying etiologies were infection in 6 cases (23%), disturbance in skeletal development in 7 cases (27%), benign tumorous lesion in 10 cases (38%) and malignant tumorous lesion in 3 cases (12%). 3. The most common site was femur, 54% (14 cases). 4. Previous treatment was carried on 38% (10 cases). 5. Of the 26 cases, conservative treatment was done in 4 cases (15%) and surgical treatment was done in 22 cases (85%).
Age Distribution ; Clinical Study ; Female ; Femur ; Fractures, Spontaneous ; Humans ; Male ; Osteoporosis ; Skeleton

PURPOSE: A heterotopic pancreas is defined as one for which pancreatic tissue is present outside its usual or habitual location and without an anatomic relation either of continuity or of vascularization with the pancreas proper. Most heterotopic pancreases are incidentally encountered during surgery, and on rare occasions, epigastric pain, weight loss, hemorrhage, gastric outlet obstruction, and intussusception have been directly attributable to the presence of a heterotopic pancreas. The purpose of this article is to report the clinical characteristics of the heterotopic pancreas. METHOD: We retrospectively observed 24 patients, who had been pathologically proven to have a heterotopic pancreas, at the Department of Surgery, Korea University Hospital, from Jan. 1990 to Dec. 1998. RESULTS: 16 of the 24 cases were found incidentally during operations due to by other primary diseases; 8 cases were symptomatic. The ratio of males to females was 1.18:1 and most common sites were the stomach and the duodenum (71%). The mean size of the lesion was 1.26 cm, and the sizes in symptomatic cases were larger (mean 1.89 cm) than those in cases where the lesions were found incidentally (mean 0.94 cm). We experienced a case of a ductal adenocarcinoma originating from the heterotopic pancreas in the jejunum of a 73 year old man. CONCLUSION: A heterotopic pancreas should be considered in the differential diagnosis of submucosal tumors, polyps, ulceration, and intestinal tumors, When suspected, an intraoperative frozen section is recommended, and the range and the method of the operation should be decided based on the results of the frozen section.
Adenocarcinoma ; Aged ; Diagnosis, Differential ; Duodenum ; Female ; Frozen Sections ; Gastric Outlet Obstruction ; Hemorrhage ; Humans ; Intussusception ; Jejunum ; Korea ; Male ; Pancreas* ; Polyps ; Retrospective Studies ; Stomach ; Ulcer ; Weight Loss

In order to identify the characteristic ocular findings in Down's syndrome(DS), 123 Korean children with DS prospectively underwent ocular examination, including visual acuity assessment, slit-lamp biomicroscopy, ocular motility, cycloplegic refraction, and ophthalmoscopy. The ocular findings in decreasing prevalence were the following:upward slanting of the palpebral fissure(78 patients, 63%), epicanthus(75 patients, 61%), epiblepharon(66 patients, 54%), astigmatism(38 patients, 31%), hyperopia(35 patients, 28%), myopia(31 patients, 25%), strabismus(31 patients, 25%, 18 esotropia and 13 exotropia), nystagmus(27 patients, 22%), nasolacrimal duct obstruction(21 patients, 17%), blepharoconjunctivitis(20 patients, 16%), retinal abnormalities(18 patients, 15%), cataract(4 patients, 13%), and glaucoma(1 patient, 0.8%). Brushfield spots and keratoconus were not found. The ocular findings in Korean children with DS are characterized as an unreported, high incidence of epiblepharon, the highest rate of exotropia as reported, and no cases of Brushfield spots. The difference in the incidence of these ocular abnormalities according to race and age should be considered in every patient with DS.
Child* ; Continental Population Groups ; Down Syndrome* ; Esotropia ; Exotropia ; Humans ; Incidence ; Keratoconus ; Nasolacrimal Duct ; Ophthalmoscopy ; Prevalence ; Prospective Studies ; Retinaldehyde ; Visual Acuity

Extraskeletal Ewing's sarcoma is a rare primary malignant soft tissue tumor that has the same pathological characteristics of skeletal Ewing's sarcoma. It is known that the differential diagnosis of Ewing's sarcoma from undifferentiated rhabdomyosarcoma, neuroblastoma, reticulum cell sarcoma, and malignant lymphoma by the histologic studies only are not easy because their histologic findings are nearly similar each other. Therefore, immunohistochemical method, electron microscopic examination, cytogenetic study, or molecular gene study are used together to confirm the diagnosis. It chiefly involves the lower extremity, soft tissues of the paravertebral region, and adjacent chest wall. We recently experienced a case of extraskeletal Ewing's sarcoma of duodenum in a 21-year old female. The patient underwent Whipple's operation and postoperative combined chemotherapy were done.
Cytogenetics ; Diagnosis ; Diagnosis, Differential ; Drug Therapy ; Duodenum* ; Female ; Humans ; Lower Extremity ; Lymphoma ; Lymphoma, Non-Hodgkin ; Neuroblastoma ; Rhabdomyosarcoma ; Sarcoma* ; Sarcoma, Ewing ; Thoracic Wall ; Young Adult

OBJECTIVE: Although there are many reports describing the risk of rebleeding in hospitalized patients with subarachnoid hemorrhage (SAH), it is common for these patients to deteriorate during transportation or while waiting for surgery. The aim of this study was to estimate the possible causes of neurological deterioration in patients with a ruptured aneurysm prior to hospitalization and management and the effect on patient prognosis. METHODS : Two hundred and thirty patients with aneurysmal SAH that arrived to the hospital within 24 hours after the initial bleeding were recruited. The course of neurological deterioration, age, gender, Hunt and Hess grade, Fisher grade, the arterial blood pressure, the clinical findings when neurological deterioration occurred, aneurysm location and size, treatment and the outcome were analyzed. RESULTS: Among the 230 patients, 32 (13.9%) patients had neurological aggravation prior to management. Fifteen (46.8%) patients had definite rebleeding, 5 (15.6%) acute hydrocephalus and 2 (6.3%) intracerebral hematomas. Two (6.3%) patients had a cardiac arrest, and another 8 (25%) patients likely had rebleeding. Such deterioration occurred in 15 (46.8%) patients within 3 hours after the initial event and in 21 (84%) patients within 6 hours. The patients experiencing neurological deterioration had a more severe Hunt and Hess grade, higher rates of intracerebral hematoma and intraventricular hematoma, reduced operability, and a poorer prognosis. CONCLUSION: The findings showed that neurological deterioration occurred much earlier than expected. Thus, more rapid and careful preoperative management and earlier neurosurgical intervention might prevent neurological deterioration and improve patient outcome.
Aneurysm ; Aneurysm, Ruptured ; Arterial Pressure ; Heart Arrest ; Hematoma ; Hemorrhage ; Hospitalization ; Humans ; Hydrocephalus ; Prognosis ; Subarachnoid Hemorrhage ; Transportation

PURPOSE: To evaluate the usefulness and radiologic findings of CT in the diagnosis of orbital blow-outfracture. MATERIALS AND METHODS: Forty-four patients with orbital blow-out fractures diagnosed by clinicalfindings and CT were evaluated retrospectively. On CT images, we evaluated the site and frequency of fracture,herniation of orbital fat, extraocular muscle abnormality, intraorbital hematoma, and intrasinus hemorrhage. RESULTS: Forty-eight sites of orbital wall fractures were seen. Of these, 25(52.1%) were observed at the medialwall and 18(37.5%) at the inferior wall. Combined fracture of the medial and inferior wall was seen in fivecases(10.4%), and orbital fat herniation to adjacent sinuses in 25. Associated extraocular muscle abnormalitieswere seen at the medial rectus (n=20) and inferior rectus muscle(n=18). Intrasinus hemorrhage was seen in 15cases, and intraorbital hematoma in five. CONCLUSION: CT is a useful diagnostic modality for the evaluation oforbital blow-out fracture and associated soft tissue abnormalities.
Diagnosis ; Hematoma ; Hemorrhage ; Humans ; Orbit* ; Orbital Fractures* ; Retrospective Studies