PURPOSE: Congenital anomalies are known as a major cause of neonatal death with prematurity and birth injuries. We surveyed the incidence of congenital anomalies among livebirths and stillbirths delivered at our hospital, and detected in neonatal and postneonatal period. METHODS: The statistical study was done about congenital anomalies among 9,569 deliveries (9,438 livebirths and 131 stillbirths) at Ulsan University Hospital during the periods of 5 years from Jan 1992 to Dec 1996. We reviewed delivery and newborn record, OPD chart, admission chart retrospectively. We investigated the incidence of congenital anomaly according to each year, period, outcome of delivery, sex, birth weight, gestational age, maternal age, Apgar score, multiple pregnancy, and each system. RESULTS: 1) The overall incidence of congenital anomalies was 5.0% (481 cases) among 9,569 deliveries. The annual incidence was 4.5% in 1992, 5.1% in 1993, 5.2% in 1994, 5.8% in 1995, 4.7% in 1996. 2) The incidence of congenital anomalies detected in neonatal period was 3.5% (333 cases) and 1.5% (148 cases) in postneonatal periods. 3) The incidence of congenital anomalies was 4.9% among live births and 9.2% among stillbirths. 4) The incidence of congenital anomalies was 5.3% in male and 4.7% in female. 5) The incidence of congenital anomalies among the babies, below 2,500g of birth weight was 7.7%, between 2,500g and 3,999g was 4.7%, and over 4,000g was 6.8N. 6) The incidence of congenital anomalies among the babies, below 32 weeks of gestational age was 12.9%, between 32 weeks and 36 weeks was 7.4%, between 37 weeks and 41 weeks was 4.7%, and over 42 weeks was 5.1%. 7) The babies born to mothers younger than 20 years of age have anomalies in 7.1%, mother between 20 years of age and 35 years of age in 5.0%, and older than 35 years of age in 6.5%. 8) The incidence of congenital anomalies according to Apgar score among live births between 0 and 3 was 9.8%, between 4 and 6 was 6.0%, and between 7 and 10 was 5.0%. 9) The incidence of congenital anomalies according to multiple pregnancy was 8.6%. 10)The systems of congenital anomalies in order of incidence were as follows; The digestive system (25.6%), the cardiovascular system (22.1%), the genitourinary system (18.9%), the musculoskeletal system (15.5%), the skin and soft tissue (11.7%), the central nervous system (1.6%), the respiratory system (l%), the others (3.6%). CONCLUSIONS: Regular examination and screening on congenital anomaly is required from newborn period to infant and childhood. In view of these considerations, the incidence of congenital anomaly may be increased more than the past reports because of development of recent diagnostic techniques.
Apgar Score ; Birth Injuries ; Birth Weight ; Cardiovascular System ; Central Nervous System ; Digestive System ; Female ; Gestational Age ; Humans ; Incidence ; Infant ; Infant, Newborn ; Live Birth ; Male ; Mass Screening ; Maternal Age ; Mothers ; Musculoskeletal System ; Pregnancy ; Pregnancy, Multiple ; Respiratory System ; Retrospective Studies ; Skin ; Statistics as Topic* ; Stillbirth ; Ulsan ; Urogenital System

The distal tibial physeal plate is the second most frequently injured physis and the percentile incidence of its injury is reported to reach 11 percent of all physeal injuries. After physeal injuries, many complications may follow such as angulatory deformity, incongruity of the joint surface, and growth disturbance, which are well recognized. Therefore, for preventing these complications, we have to know mechanism of injury and position of foot in injury. There are several published articles about classification of these injuries. The first traumatological classification of ankle injuries in children is the one proposed by Bishop. Although there were many reports about classification since Bishop, those did not mention the position of foot in injury. Recently a modified classification by Dias and Tachdjian added the postiton of the foot during injury to the direction of the force as Lauge-Hansen did. There were only few reports about epiphyseal and physeal injuries of the ankle in Korea. Also, we could not find the reports which dealt with more than forty cases. The authors have made a clinical analysis on forty cases of childrens ankle fractures, and among them twenty-two could be followed over a year, who were treated at the Department of Orthopaedic Surgery, Kang-Nam St. Marys Hospital, from June 1981 to December 1986. Children were in age of 3 to 16 years. Forty cases were classified according to modified Dias and Tachdjians. 15 out of 40 cases (37.5%) had supination and external rotation injury, which is the most frequent mechanism of injury in this series. However, one case (2.5%) which was suspected to be axial compression type could not be accommodated to this classification. Twenty-seven cases were treated by gentle closed reduction and immobillization in a plaster cast, and thirteen by open reduction and internal fixation. Among the 22 cases who were followed over a year, five cases had complications, such as angulatory deformity, incongruity of the joint surface, and growth disturbance. Three cases out of these five cases had incongruity of the joint surface.
Ankle Fractures ; Ankle Injuries ; Ankle ; Casts, Surgical ; Child ; Classification ; Congenital Abnormalities ; Foot ; Humans ; Incidence ; Joints ; Korea ; Supination

The intra-articular osteochondroma arising from soft tissue is very rare and has been reported less than a dozen cases in the English literature. This tumor is the result of extrasynovial metaplasia of the fibrous capsule or of the adjacent connective tissue of a joint. The authors experienced a case of giant intra-articular osteochondroma of the right knee in a 37 year-old man which arised from the medial meniscus. Histology as well as gross findings were consistent with osteochondroma. Excision of the mass with attached meniscus relieved symptoms. No recurrence, or malignant change was identified up to 1 year after excision.
Connective Tissue ; Joints ; Knee ; Menisci, Tibial ; Metaplasia ; Osteochondroma ; Recurrence

Transarterial chemoembolization is often the first-line treatment for multiple hepatocellular carcinomas. However, hepatic arterial infusion chemotherapy is a treatment option for hepatocellular carcinoma refractory to multiple sessions of transarterial chemoembolization. Hepatic arterial infusion chemotherapy requires implantation of an appropriate port into the hepatic artery. However, it may be impossible to implant a port due to hepatic artery variation. We report a case of hepatocellular carcinoma refractory to transarterial chemoembolization and hepatic artery variation treated successfully with hepatic arterial infusion chemotherapy and radiofrequency ablation with complete response after implantation of ports in both liver lobes.

Paraneoplastic pemphigus is a distinct and rare autoimmune disease characterized by extensive and painful mucosal ulcerations and polymorphic desquamated skin lesions in the setting of an underlying neoplasm, typically of lymphoreticular origin. Thus difficulties in the management of anesthesia can be expected. A 66-years-old man was scheduled for removal of intraabdominal sarcoma associated with paraneoplastic pemphigus. Physical examination showed multiple erythematous bullae, crusts, plaques and target-like lesions on the whole body and desquamated erythematous skin lesions on the back and extremities. In the operating room, his right femoral artery was cannulated with a 20 G, 12.7 cm CVP catheter and left femoral and subclavian veins with 14 G, 20 cm CVP catheters, respectively. After application of 4 % lidocaine spray, his oropharynx and supraglottic area were evaluated under direct laryngoscopy and revealed multiple ulcerations on oral mucosa, but no distinct lesion on supraglottic area. Anesthesia was induced by rapid-sequence method with fentanyl, thiopental sodium and succinylcholine followed by endotracheal intubation. The endotracheal tube was held by a roll gauze around the neck and its cuff was minimally inflated to avoid overpressure against his tracheal wall. After the end of surgery, his oral cavity was suctioned with no remarkable bleeding, and tracheal wall including cuff-contacted area was evaluated under fiberoptic bronchoscopy, revealed intact wall without any bulla or ulceration. The patient was transferred to intensive care unit for proper postoperative management after extubation of endotracheal tube.
Anesthesia ; Autoimmune Diseases ; Bronchoscopy ; Catheters ; Extremities ; Femoral Artery ; Fentanyl ; Hemorrhage ; Humans ; Intensive Care Units ; Intubation, Intratracheal ; Laryngoscopy ; Lidocaine ; Mouth ; Mouth Mucosa ; Neck ; Operating Rooms ; Oropharynx ; Pemphigus* ; Physical Examination ; Sarcoma ; Skin ; Subclavian Vein ; Succinylcholine ; Suction ; Thiopental ; Ulcer

No abstract available.
Erectile Dysfunction* ; Evoked Potentials, Somatosensory* ; Male

Crossed renal ectopia is an unusual congenital anomaly, probably produced by abnormal development of the ureteral bud. The deformity itself produces no symptoms and the clinical presentation generally is for obstruction and infection. The pediatric patients present most often with multiple congenital anomalies, especially of the skeletal system. We report the two cases of crossed renal ectopia with fusion with review of literatures.
Congenital Abnormalities ; Humans ; Ureter

Currently, various tyrosine kinase inhibitors and immune checkpoint inhibitors have been suggested in the treatment guidelines for advanced hepatocellular carcinoma (HCC). However, sorafenib was the only systemic drug approved 10 years ago. In 2010, a woman diagnosed with HCC rupture and multiple lung metastases visited our hospital. At the time of visiting our hospital, she had undergone transarterial chemoembolization at another hospital to control bleeding due to HCC rupture. We treated her with hepatic arterial infusion chemotherapy and sorafenib combination therapy to increase the control of intrahepatic tumors in consideration of the modest efficacy of sorafenib. The intrahepatic tumor was almost controlled. Metastasectomy was performed to control lung oligometastasis. Subsequently, additional muscle metastasis was confirmed, and metastasectomy was performed. Although this is a very rare case, it shows that a multidisciplinary approach can improve the prognosis of patients with HCC.

No abstract available
Mycosis Fungoides*

The dorsal ulnar cutaneous nerve (DUCN) is the sensory branch of ulnar nerve supplying sensation to the dorsal ulnar aspect of the hand. Isolated DUCN injury is known rare. We report 3 cases of isolated DUCN injury caused by stretch injury and mild blunt injury during activities of daily living. Isolated DUCN injury may more frequently occur than we thought. Nerve conduction study and ultrasonography are useful method to localize the lesion and to evaluate the structural etiology.
Activities of Daily Living* ; Hand ; Methods ; Neural Conduction ; Sensation ; Ulnar Nerve ; Ulnar Neuropathies ; Ultrasonography ; Wounds, Nonpenetrating