There are many complications related to paralyzed patients. Heterotopic ossification in pressure sore patients is reported to be rarely developed, but once it occurs, it frequently causes joint stiffness which may aggrevate the pressure sore wound. This paper was based on a clinical study of heterotrophic ossification in 6 quadriplegic and paraplegic patients from 1988 to 1997 at St. Paul's Hospital. All were males aged between 22 and 58 years (mean age, 45.5 years). The sites of pressure sore were in the ischial and trochanteric areas. Heterotopic ossification had developed around the hip joint and the ischial area. The mean onset time was 3.6 years (minimum 10 months maximum 8 years) after trauma. Plain X-ray, bone scan CT and pathological examination were helpful in confirming the diagnosis of heterotopic ossification. The mechanism of heterotopic ossification is not exactly known, but chronic trauma or inflammation could be one etiology. There are still many difficulties in management of heterotopic ossification, but prevention is the most important treatment.
Diagnosis ; Femur ; Hip Joint ; Humans ; Inflammation ; Joints ; Male ; Ossification, Heterotopic* ; Pressure Ulcer* ; Wounds and Injuries

A clinical observation of tattoos was made during physical exarnination for conscription in Choongchengnarndo and northern area of Seoul from April to August, 1988. The result were as follows : 1. The most common educational level of tattoo pstient was in the middle school graduated group (55.9%). 2. The average age when first tattoo was made was 17.3% years. 3. Left arm was the most favorite site (44.45b). 4. Most of motivation for being tattooed was curiosity, heroism, for fun(51.2%). 5. Girl friends name, heart or heart and arrow, rose and one-mind were the most common contents of tattoos. 6. The average number of tattoo was 2.5. 7. More Tattoos were tattooed by themselves than by others (55.9%). 8. Most common tattoo material was chinese ink. 9. The complications of tattoo were found in 23 case (5.2%); hypertropic scar, keloid, post inflammatory hyper/hypo pigmentation and pyoderma. 10. The removal of tattoos were tried in 95 case (21.6%). The most frequent methods used were cigarette burning and scratching with a knife.
Adolescent* ; Arm ; Asian Continental Ancestry Group ; Burns ; Cicatrix ; Exploratory Behavior ; Female ; Friends ; Heart ; Humans ; Ink ; Keloid ; Motivation ; Pigmentation ; Pyoderma ; Seoul ; Tobacco Products

No abstract available.
Carcinoma, Basal Cell* ; Dermoscopy*

Pressure sores are common complications in patients with spinal injuries or cerebrovascular accidents. The management of pressure sores requires prolonged hospitalization and repeated surgical interventions with a high recurrence rate. Particularly osteomyelitis following initial pressure sores persistently complicates wound healing and recovery. Furthermore, it may also ultimately result in serious sepsis; thus an early diagnosis of osteomyelitis in pressure sore patients is crucial along with appropriate surgical and antibiotic therapy. Although many diagnostic methods were reported, there is no single 'gold' standard for early diagnosis of pressure sore-associated osteomyelitis. Authors reviewed pre-operative CBC, plain X-ray, Tc-99m bone scan, and post-operative biopsy results in 37 patients who had received surgical treatment for pressure sores in a 5-year period from September 1991 to August 1996. Based on these reviews, authors compared and analyzed the sensitivity and specificity in diagnosing osteomyelitis.The results were as follows: 1. Of 37 patients studied, 25 cases were confirmed histologically as osteomyelitis. Ischial region revealed the highest incidence of pressure sore-related osteomyelitis(78%, 14 out of 18 cases) while the regional incidence was as following in descending order : ischial, sacral, and greater trochanteric area. 2. Tc-99m bone scan had superior sensitivity(100%) and specificity(83%) to other pre-operative studies in diagnosing osteomyelitis.In conclusion, authors suggest that Tc-99m bone scan is the best diagnostic method because of its high sensitivity and specificity if osteomyelitis is clinically suspected in pressure sore patients. And in case the test result is positive, agressive surgical bone resection and appropriate antibiotic therapy based on bacterial culture from deep bone specimen should be combined to prevent complications or recurrences.
Biopsy ; Early Diagnosis ; Femur ; Hospitalization ; Humans ; Incidence ; Osteomyelitis ; Pressure Ulcer* ; Recurrence ; Sensitivity and Specificity ; Sepsis ; Spinal Injuries ; Stroke ; Wound Healing

No abstract available.
Sterilization, Tubal*

The first ray, including the hallux and first metatarsal, has historically been the most common location of congenital and functionally acquired deformities of the lower extremity. It has been the subject of extensive historical review and study as an untold number of authors and surgeons have directed their talents toward the comprehension and correction of the condition. But, few reports have been made on that subject in Korean population. So, we made a clinical and radilogical study of the hallux valgus angle (HVA), intermetatarsal angle (IMA) and hallux valgus in 200 Korean population. The results obtained were as follows: 1. The mean value of HVA was 14.8°±4.6° in male and 17.6°±5.4°in female. The mean value of HVA of the hallux valgus patient was 33° 2. The mesn value of IMA was 8.6°±1.9°in male and 10.2°±2.2°in female. The mean value of IMA of the hallux valgus patient was 14° 3. The incidence of hallux valgus was 11% in male, 37% in female and female was 77% of all hallux vslgus patient. 4. The family history of hallux valgus was found in 63% and 94% of patients has bilateral involvement. 5. The most common chief complaint was pain over the medial side of the first MP joint or base of the other metatarsal bone. Symptoms were not correlated with angle value. 6. In the first MP joint of hallux valgus by Piggott, the deviated joint was most common (52%). 7. In the three basic MP joint types by Haas, the round metatarsal head was most common. 8. DASA was ranged from 0°to 7°in normal persons and from 2°to 16°in hallux valgus patients. 9. PASA was ranged from 1°to 9°in normsl persons and from 3°to 35°in hallux valgus patient. 10. The tibial sesamoid displacement more than grade 4 by Haas rating system was found 63% of hallux valgus patients.
Aptitude ; Asian Continental Ancestry Group ; Comprehension ; Congenital Abnormalities ; Female ; Hallux Valgus ; Hallux ; Head ; Humans ; Incidence ; Joints ; Lower Extremity ; Male ; Metatarsal Bones ; Surgeons

No abstract available.
Bony Callus* ; Coinfection* ; Epidermal Cyst*

BACKGROUND: Smoking-related chronic obstructive pulmonary disease and chronic asthmatic bronchitis, which are the most important causes of chronic airflow obstruction (CAO), can occur together in a pat,ient and the prognoses of these two diseases are different each other. OBJECTIVE AND METHOD: To estimate the extent of asthmatic component in patients with CAO and to evaluate the role of atopy as a predictable index for reversibility of airflow obstruction, 89 CAO patients who were older than 40 years were examined retrospectively. RESULT: Only 15 patients (16.8%) showed an increase of >15% in FEV20 to inhaled salbutamol (short-term responder). However, 18 out of 32 patients (56.3%), who were not responded significantly to inhaled bronchodilator and performed a follow-up lung function study, showed an increase of ) 15% in FEV20 to anti-asthmatic therapy including corticosteroid for 3-4 weeks (long-term responder). Peripheral blood eosinophil count only was different between short-term responder and short-term nonresponder, and there was no difference in all of the measurements between short-term responder and long-term responder. However, there were significant differences in smoking, wheezing on auscultation, peripheral blood eosinophil counts, serum total IgE levels, and MAST atopy score between long-term responder and long-term nonresponder. The increase in FEV, following shortor long-term therapy was related to peripheral blood eosinophil counts and MAST atopy score, and it was significantly great,er in patients with high eosinophil counts or high atopy score. CONCLUSION: About 2/3 of patients with CAO who were older than 40 years had an asthmatic component ap atopy may be useful to predict good bronchodilator response to anti-asthmatic therapy.
Albuterol ; Auscultation ; Bronchitis ; Eosinophils ; Follow-Up Studies ; Humans ; Immunoglobulin E ; Lung ; Prognosis ; Pulmonary Disease, Chronic Obstructive* ; Respiratory Sounds ; Retrospective Studies ; Smoke ; Smoking

BACKGROUND: The purpose of this study was to determine the efficacy and safety of the anterior vaginal wall sling in the management of women with stress urinary incontinence. MATERIALS AND METHODS: From January 1998 to December1999, 42 patients(31 with genuine stress urinary incontinence and 11 with mixed urinary incontinence, 38 with anatomical incontinence and 4 with intrinsic sphincteric deficiency) underwent anterior vaginal wall sling at Yeungnam University Hospital were studied retrospectively. The mean age was 49.3 years(ranging from 34 to 66 years of age) and the mean follow-up period was 29.4 months(ranging from 16 to 40 months). Intra- and postoperative complication, success rate and patient's satisfaction were evaluated. RESULTS: The mean operation time was 79 minutes(ranging from 65 to 124 minutes) and the mean hospital stay was 5.1 days(ranging from 4 to 10 days). Mean postoperative Foley catheter drainage was 2.1 days(ranging from 1 to 5 days). As a complication, bladder perforation occurred in one patient(2.4%), residual urine sensation developed in seven patients(16.7%). and suprapubic pain was complained in five patients(11.9%). which improved gradually. Vaginal epithelial inclusion cyst occurred in one patient(2.4%) at postoperative 31 months. Four(9.4%) patients with de novo instablility were improved by anticholinergics medication. The success rate was 92.9% and 38 patients(90.5%) were satisfied with this procedure. CONCLUSION: We consider that the anterior vaginal wall sling to be a safe and effective surgical procedure for the treatment of female stress urinary incontinence. but a longer follow-up is necessary to determine long term effect.
Catheters ; Cholinergic Antagonists ; Drainage ; Female* ; Follow-Up Studies ; Humans ; Length of Stay ; Postoperative Complications ; Retrospective Studies ; Sensation ; Urinary Bladder ; Urinary Incontinence*

No abstract available.
Thrombosis* ; Veins*