We studied 30 patients who participated in accelerated rehabilitation program after ACL reconstruction to evaluate the effects on knee joint function prospectively. This program emphasizes early full hyperextension, early weight bearing as tolerated, and closed-chain quadriceps functional activities with rapid return to sports. Timing of the return to occupation, activity level, manual knee test, range of motion, thigh circumference, Lysholm knee score and KT-2000 arthrometer measurement were checked at the latest follow-up which is at least more than 1 year. The result were as follows: 1. The mean time for patients to return to occupation was 7.5 weeks (2 weeks-6 months). 2. Range of motion of the knee were not limited in 25 cases (83%) at 1 year after reconstruction. 3. The mean Lysholm score was 92.7. 4. The mean manual maximum KT-2000 arthrometer score was 2.0mm. The results of this study show that patients who had an ACL reconstruction with an autogenous central 1/3 patellar tendon graft and followed an accelerated rehabilitation program obtained longterm stability, achieved full range of motion, had a low complication rate, and were able to return to full sporting activities predictably.
Follow-Up Studies ; Humans ; Knee Joint* ; Knee* ; Occupations ; Patellar Ligament ; Prospective Studies ; Range of Motion, Articular ; Rehabilitation* ; Sports ; Thigh ; Transplants ; Weight-Bearing

This study analyzed the factors causing the angular deformity as the tibia fracture below isthmus were treated with interlocking nails. For this purpose, we observed 70 cases of tibia fractures in the Gil General Hospital as subjects. Of the 70 cases under the treatment, 32(45.7%) showed the angulation of over one degree, and 11(15.7%) showed that of 5-10 degrees in any plane. According to the outcomes of this studies, the degree of angulation seemed to have close relation to the length of fracture line. Also, if the fracture line reached to the isthmus, angulation was apt to be caused. Even though most angulated cases had concomitant fibular fracture, fibular fracture, itself, seemed to have no direct relation to angulation. In consequence, the intramedullary interlocking nailing needs special carefulness in the case of breakage of cortical buttress such as long fracture line, butterfly fragment and fracture including isthmus.
Butterflies ; Congenital Abnormalities* ; Hospitals, General ; Tibia*

A cyst in the accessory parotid gland (APG) is extremely rare, with only three cases having been reported recently in English literature. They were all treated with sclerotherapy, where a cyst may appear as a painless superficial mass in the mid-cheek area. In sclerotherapy, the most commonly used materials are ethanol and OK-432, which report good therapeutic results for the treatment of benign cervical cystic mass. An 85-year-old man came to our clinic with superficial, well-margined ovoid mass on the left cheek. The mass was diagnosed as a benign cyst in APG through imaging studies and core needle biopsy. We performed the ultrasoundguided percutaneous ethanol injection and the cyst disappeared, leaving only the fused cystic wall. We report this very rare and interesting case with a literature review.

Extrapulmonary small cell carcinoma originated from the paranasal sinus is extremely rare, and its local and distant metastasis is common and the prognosis is poor. We recently experienced a rare case of small cell carcinoma that originated from the maxillary sinus. However, the diagnosis was delayed for several reasons, one of which included accompanied bilateral fungal sinusitis. The patient received chemotherapy for four times, but the therapy was discontinued due to poor general conditions. We report our case with a review of the literature.

Parathyroid carcinoma accounts for about 0.5%-5% of all parathyroid neoplasms. Very rarely, but if the intrathyroidal parathyroid gland is present, the carcinoma can arise in that developmental anomaly. It is very difficult to distinguish a thyroid nodule from an intrathyroidal parathyroid neoplasm with preoperative radiologic and cytologic evaluations. A 59-year-old male was initially evaluated as presenting a follicular thyroid neoplasm accompanied by hyperparathyroidism. He received hemi-thyroidectomy with central neck dissection and subtotal parathyroidectomy. The final pathology evaluation revealed intrathyroidal parathyroid carcinoma and hyperplasia of contralateral parathyroid glands. We report this very rare and unique clinical situation with a literature review.

Herniation of the temporomandibular joint (TMJ) into the external auditory canal is rare as TMJ and external auditory canal are separated by an anterior bony wall of external auditory canal. The bony defect of the anterior external auditory canal can be caused by trauma, otologic procedure, neoplasm, inflammation and a rare congenital bony defect. Conservative treatment is available if the severity of the symptom is mild or asymptomatic. However, surgical procedure is considered if the patient experiences severe distress. There have been no reported cases of surgical-related complications and recurrence during postoperative follow-up period. Herein we report the very first case of foreign body prolapse involving herniation from TMJ extending into the external auditory canal.

Malignant melanoma can be classified as both cutaneous and mucosal types. The former comprises more than 98% of all melanomas and is related to ultraviolet exposure, whereas the latter occupies only 1.3%. More than half of mucosal melanoma arises in the head and neck region, and the sinonasal tract is also one of its predilection sites. On the other hand, the metastatic melanoma of head and neck is lower incidence than primary lesion and the unknown primary site is about two to five percent. Moreover, a lymphatic metastasis to the posterior neck is a more unusual clinical pattern. A 71-year-old man with a solitary subcutaneous posterior neck mass visited our clinic. He was confirmed with metastatic melanoma in the lymph node through excisional biopsy. However, the primary site was not found with whole radiologic examinations. We report a very rare disease entity with a brief literature review.

Schwannomas are slow-growing, benign neurogenic tumors arising from the sheath of myelinated nerve fibers. They usually occur in the head and neck region. Only 4% of schwannomas found in the head and neck region originate in the sinonasal tract. Schwannoma of the nasal septum is rarer, and only few cases have been previously reported in the literature. We experienced a rare case of the schwannoma of the posterior nasal septum in a 71-year-old woman. She was treated successfully by transnasal endoscopic surgery. No recurrence was detected within 18 months follow-up period.

Epidermal cysts are generally benign tumors that usually originate from the skin caused by inflammation of hair cortex and proliferation of epidermal cells within the dermis; however, for these cysts to occur in the bony external auditory canal (EAC) is rare. They are often present as a solitary, painless lesion and usually asymptomatic and the diagnosis depends on the results of the histological examination. In treatment, the cyst wall must be completely removed surgically. We recently encountered a 82-year-old male with a mass in the right EAC. An otoscopic examination showed a polypoid mass on the bony EAC, which was finally diagnosed as epidermal cyst after an initial misdiagnosis as EAC carcinoma. We report the rare, unique case with literature review.
Aged, 80 and over ; Dermis ; Diagnosis ; Diagnostic Errors ; Ear Canal* ; Epidermal Cyst* ; Hair ; Humans ; Inflammation ; Male ; Skin

Warthin's tumor (WT) is second most common neoplasm in the parotid gland and it can be accompanied by inflammation and necrosis. The chest wall inflammation may present a rapid and fatal clinical course and secondary to parotid abscess is extremely rare. An 81-year-old man came to emergency room complained of rapidly enlarged left parotid mass and inflammatory symptoms and signs around the upper lateral neck. We performed incision and drainage with adequate infection control. He was pathologically diagnosed as abscess. We report the unique and instructive clinical case with a literature review.
Abscess ; Aged, 80 and over ; Drainage ; Emergency Service, Hospital ; Humans ; Infection Control ; Inflammation ; Neck ; Necrosis ; Parotid Gland ; Thoracic Wall ; Thorax