No abstract available.
Mandibulofacial Dysostosis*

Bizarre parosteal osteochondromatous proliferation was first described in 1983, when Nora and his collegues reported 35 examples of a proliferative lesion involving bones of the hands and the feet. In 1993, Meneses reported 65 cases of this condition. A fourth of all the reported cases involved the long bones. It is important to identify the clinical, roentgenographic, and histologic characteristic to seperate it from other entities because it is a benign lesion with atypical microscopic features with a tendency to recur. Roentgenograms show a calcific mass attached to the underlying cortex having a broad base. Histologically, the lesion exhibites proliferative activity, irregular bony cartilaginous interfaces, and enlarged, bizarre, and binucleated chondrocytes. We reviewed the bone tumors, diagnosed in the KyungHee University Hospital, dated from 1984 to 1994. Five cases were revised to Nora's lesion, all of which were previously diagnosed as osteochondroma. The ages of the patients ranged from 12 to 57 years (median, 19 years), and all of them were males. Two cases involved the bones of hands and feet (metacarpal and talus), and 3 cases involved the long bones (humerus, fibula, and ulna). One lesion involving the humerus has a recurrence. No metastasis had been reported.
Neoplasm Metastasis

No abstract available.
Humans ; Infant, Newborn*

Twenty nine cases of wrist tuberculosis were reviewed(19 joint involvement cases and 4 tendon involvement cases) and twenty three cases were followed up more than one and half years. The mean follow up period was 26.7 months. Synovectomies were not satisfactory in cases of joint involvement and they were useful only in cases of tendon involvement. Arthrodesises were used for 16 cases of joint involvement and were satisfactory in 87,5 percent by Robin's criteria. Finger stiffness was most serious complication(initially, 8.7 percent and finally, 34.8 percent) and it is suggested that early motion of fingers after arthrodesis can prevent this complication.
Arthrodesis ; Fingers ; Follow-Up Studies ; Joints ; Tendons ; Tuberculosis ; Wrist

Preoyerative sedation of children is a difficult problem of great importance, for the psychic trauma comsequent to anticipation of surgery may be as great a hazard to the patient as his original disease. Until now, a number of sedatives have been used commonly for adequate sedation of pediatric patients, but, no method has been universally accepted. At our hospital fifty pediatric patients receiving general anesthesia for minor elective surgery were studied to evaluate the effect of ketamine hydrochloride as a preanesthetic agent. The results were as follows: 1) The onset of drag action was about, about 5min. 2) The induction of anesthesia and maintenances of operation was smooth, because a sedative effect was obtained without cardiovascular and respiratory depression. 3) With a small dosage of ketamine(2mg/kg), patients were free from apprehension. So, perioperative psychic trauma was preventible. 4) The two excitable patients were anesthetized by intravenous anesthetics with ease. 5) Mild complications, accurred but they were not significant.
Anesthesia ; Anesthesia, General ; Anesthetics, Intravenous ; Child* ; Humans ; Hypnotics and Sedatives ; Ketamine* ; Methods ; Respiratory Insufficiency

Inflammatory pseudotumor of the Aver is a rare benign lesion that usually has been discovered at laparotomy. This lesion is inflamrhatory and reactive, but the etiology remains unknown. In-flammatory pseudotumor of the liver is of the interest not only because of its rarity also because it needs to be clinically differentiated from hepatocellular carcinoma and other malignant tu-mors. In this report, we describe a case of inflammatory pseudotumor of the liver with fever and weight loss in a 46-year-old male. Grossly, the lesion showed a rather well demarcated, gray white to pale yellowish nodular mass mesuring 7 x 5.5 x 5 cm in dimensions. M icroscqpically, the tumor was composed of diffuse infiltration of predominantly plasma cells, lymphocytes and histocytes associated with fibroblastic proliferation.
Carcinoma, Hepatocellular

BACKGROUND/AIMS: Risk factors for infection in patients undergoing hemodialysis during dual lumen catheterization have not been adequately defined. We investigated risk factors associated with Staphylococcal bacteremia (SB) in patients undergoing hemodialysis using a catheter. METHODS: Patients undergoing hemodialysis with a catheter were categorized into either the SB group (n=43) or control group (n=44). Data on patient demographics, the presence of underlying diseases, antibiotic use, APACHE II scores, and laboratory findings were collected retrospectively. RESULTS: Patients in the SB group tended to be older, and underwent dialysis upon admission more frequently, as compared with controls. In addition, the SB group had higher APACHE II scores, BUN, and lower creatinine levels upon admission, as compared with the control group. A multivariate analysis showed that dialysis upon admission was a risk factor for SB in patients undergoing hemodialysis using a catheter. Patients with Staphylococcus aureus bacteremia (SAB) also tended to be older and showed a higher incidence of both dialysis upon admission and antibiotic therapy prior to catheterization, as compared with the control group. Patients with SAB also had higher APACHE II scores, BUN and creatinine levels upon admission. Antibiotics prior to catheterization, higher creatinine levels, and dialysis upon admission were all independent risk factors for SAB. Patients with methicillin-resistant SB had lower albumin and creatinine levels than those with methicillin-susceptible SB. The incidences of catheterization in the general ward or ICU and antibiotic therapy prior to catheterization were both higher in the methicillin-resistant SB group. Catheterizations in the general ward or ICU and antibiotic therapy prior to catheterization were both independent risk factors for methicillin-resistant SB. CONCLUSIONS: In patients undergoing hemodialysis with a catheter, dialysis upon admission was an independent risk factor for SB. Additionally, antibiotic therapy prior to dual lumen catheterization was a risk factor for methicillin-resistant SB.
Anti-Bacterial Agents ; APACHE ; Bacteremia ; Catheterization ; Catheters ; Creatinine ; Demography ; Dialysis ; Humans ; Incidence ; Methicillin Resistance ; Multivariate Analysis ; Patients' Rooms ; Renal Dialysis ; Risk Factors ; Staphylococcus aureus

PURPOSE: The purpose of this study was to identify the levels of relocation stress syndrome (RSS) and influencing the stress experienced by Intensive Care Unit (ICU) patients just after transfer to general wards. METHODS: A cross-sectional study was conducted with 257 patients who transferred from the intensive care unit. Data were collected through self-report questionnaires from May to October, 2009. Data were analyzed using the Pearson correlation coefficient, t-test, one-way ANOVA, and stepwise multiple linear regression with SPSS/WIN 12.0. RESULTS: The mean score for RSS was 17.80+/-9.16. The factors predicting relocation stress syndrome were symptom experience, differences in scope and quality of care provided by ICU and ward nursing staffs, satisfaction with transfer process, length of stay in ICU and economic status, and these factors explained 40% of relocation stress syndrome (F=31.61, p<.001). CONCLUSION: By understanding the stress experienced by ICU patients, nurses are better able to provide psychological support and thus more holistic care to critically ill patients. Further research is needed to consider the impact of relocation stress syndrome on patients' health outcomes in the recovery trajectory.
Adaptation, Psychological ; Adult ; Aged ; Critical Illness/*psychology ; Cross-Sectional Studies ; Female ; Humans ; *Intensive Care Units ; Male ; Middle Aged ; Patient Transfer ; Questionnaires ; Stress, Psychological/*etiology ; Syndrome

BACKGROUND: Basal cell carcinoma(BCC) is the commonest type of skin malignacy, and its incidence is increasing. As a result, the number of cases requiring treatment by dermatologists may also be increasing. OBJECTIVE: The aim of this study was to clarify the presentation pattern of BCC and to assessce the surgical treatment used in the dermatological surgery clinics in Seoul National University Hospital and Seoul City Boramae Hosptial between 1994 to 1998. METHOD: We reviewed the medical records and checked clinical aspects and surgical treatment methods. RESULTS: The Total number of patients was 33. There were 21 Females and 12 males. The Mean age was 63.1. The most common anatomical site was the face and scalp(30 cases, 91%). The mean size of the tumor was 12.2 by 9.6 mm. BCCs were removed by complete surgical excision with a normal skin margin of 2 to 4 mm. The local flap was most commonly used to repair surgical wounds (55%) and primary closure was used in 39% of patients. A Pedicle flap and full thickness skin graft were also used in surgical defect reconstruction. CONCLUSION: With increasing public awareness and earlier presentation there may be a reduction in tumor size at the time of diagnosis. As most BCCs are found on the head and neck and are usually more or less than 1cm in diameter, it is thought that appropriate education of surgical skills should be needed and offered.
Carcinoma, Basal Cell* ; Diagnosis ; Education ; Female ; Head ; Humans ; Incidence ; Male ; Medical Records ; Neck ; Seoul ; Skin ; Transplants ; Wounds and Injuries*

Lymphocytic hypophysitis is a rare but important cause of pituitary hypofunction which predominantly affects young women in the peripartum period. It is believed to be an autoimmune disorder with an association with other autoimmune disorders. Clinically, it presents most frequently with symptoms and signs attributable to pituitary hypofunction, headache, visual disturbance and amenorrhea. It is difficult to distinguish lymphocytic hypophysitis from a pituitary adenoma on preoperative imaging. So the diagnosis must be confirmed pathologically. The frozen section must be done for saving the risk of permanent hypopituitarism that would have attended a more radical debulking procedure. If lymphocytic hypophysitis is confirmed by frozen section, extensive surgical debulking may not be necessary. A 31-year-old woman presented during the third trimester of pregnancy in July of 2003 with headache, vomiting and gradually progressive bilateral visual loss. There was a large 8 shaped homogeneous sellar mass on MR images before delivery. The subtotal excision of tumor was done via transsphenoidal surgery three weeks after cesarean delivery. Visual field testing revealed marked resolution of her visual field defects in both eyes. We report a case of lymphocytic hypophysitis occurred in the third trimester of pregnancy with a brief review of literatures.
Adult ; Amenorrhea ; Diagnosis ; Female ; Frozen Sections ; Headache ; Humans ; Hypopituitarism ; Peripartum Period ; Pituitary Neoplasms ; Pregnancy ; Pregnancy Trimester, Third* ; Pregnancy* ; Visual Field Tests ; Visual Fields ; Vomiting