1. A Case of osteosarcoma is reported which arose 8 years after synovima of the knee had been locally excised. The patient is a 51-year-old housewife who had received irradiation therapy upon her knee for 30 days post-operatively. Following irradiation, asymptomatic latent period lasted 8 years when mass appeared on the site, which was biopsied and diagnosed as osteosarcoma one year later. 2. This case generally suffices the McKennas criterias for irradiation-induced osteosarcoma, 3. It seems to be worthwhile to keep an eye upon the prognosis of this possible case of irradiation- induced osteosarcoma, which is largely reported to be very grave.
Humans ; Knee ; Middle Aged ; Osteosarcoma ; Prognosis ; Sarcoma, Synovial

Functional-Below-Knee Total Contact Cast characterized by early weight bearing and free motion of affected knee joint during the cast immobilizaton has brought to significant result on trearment of tibial fractures, and is considered to take early bony union by establishment of almost physiological environment on fracture site during immobilization. For recent 2 years, writers have experienced many tibial fractures to treat with Functional Below-Knee Total Contact Cast. In them, clinical data and results of 17 cases which were studied well are reviewed, and method of cast application is illustrated.
Clinical Study ; Immobilization ; Knee Joint ; Methods ; Tibial Fractures ; Weight-Bearing

No abstract available.
Ductus Arteriosus, Patent* ; Endarteritis*

Renal allograft rupture is an uncommon but life-threatening complication. The most common cause of the spontaneous rupture of the renal graft is acute rejection but other causes including acute tubular necrosis, renal vein thrombosis and urinary tract obstruction have been reported. Here we report a case of spontaneous rupture of renal graft caused by arteriovenous fistula in the patient being managed by plasmapheresis due to hemolytic uremic syndrome developed in the renal graft 3 years late after transplantation.
Allografts* ; Arteriovenous Fistula* ; Hemolytic-Uremic Syndrome ; Humans ; Necrosis ; Plasmapheresis ; Renal Veins ; Rupture* ; Rupture, Spontaneous ; Thrombosis ; Transplants ; Urinary Tract

PURPOSE: At present renal transplantation, the most frequent surgical complications may be occurred on ureterovesical anastomosis site (i.e. leakage, stenosis and reflux). The results of ureteroureterostomy using recipient's own ureter in these complications, will be presented. METHODS: From 1983 to 2004, 410 renal transplantations were performed at our institution. In all cases, external ureteroneocystostomy technique was used. Complications involving the anastomosis site occurred in 23 cases (5.4%), with 15 stenosis (3.4%) and 8 cases of leakage (1.9%). All of them were living donor cases. The mean recipient's age was 47.2 years. Corrective surgery were performed as soon as complication confirmed radiologically (ultrasonography), 16.1+/-22.3 days after transplantaion for leakage and 86.8+/-87.6 days for stenosis. If the length of graft ureter was long enough, ureteroneocys tostomy was performed again and if not, end to side ureteroureterostomy was performed in 12 cases, end to end ureteroureterostomy in 1 case and end to end pyeloureterostomy in one case. A double J ureteral stent was used in every case. RESULTS: There were one graft loss due to stone formation nephropathy, one mortality due to herpetic infection with functioning graft and one failure of recovery of graft function because of too late patients visit. Others had good graft function until last follow up with 3.8+/-2.5years of mean follow-up without further ureteral complications. CONCLUSION: Ureteroureterostomy is a safe and permanent treatment for complications of ureterovesical anastomosis site and gives good results.
Constriction, Pathologic ; Follow-Up Studies ; Humans ; Kidney Transplantation* ; Living Donors ; Mortality ; Stents ; Transplants ; Ureter

BACKGROUND: Measurements of coronary flow reserve(CFR) and phasic coronary flow profile are useful in assessment of the physiologic significance of coronary lesions. However, alterations in hemodynamic status are known to influence coronary flow reserve. The purpose of this study was to assess the effect of increase in heart rate on maximal pharmacologin coronry flow reserve and phasic flow pattern. METHODS: We investigated 12 patients(9 females and 3 males, mean age : 49+/-12 years) with normal coronary artery and atypical chest pain syndrome for the measurement of CFR and coronary flow profile. CFR and systolic and diastolic coronary flow velocity integral(CFVI) were measured at the proximal portion of left anterior descending artery with 0.018 inch(12MHz) Doppler guide wire before and during intracoronary injection of 12 mcg of adenosine. The heart rate at the baseline ranging from 62 beats/min to 79 beats/min(mean : 70+/-5 beats/min) was increased to 100 beats/min and again to 120 beats/min by right atrial pacing. RESULTS: CFR progressively decreased from 3.0+/-0.5 at baseline to 2.4+/-0.4 during pacing at 100 beats/min and to 2.0+/-0.3 during pacing at 120 beats.min(p<0.001). CFVI/min at baseline was progressively increased(130+/-15% of control value at 100 beats.min, 135+/-30% at 120 beats.min(p<0.01) whereas in adenosine hyperemia remained unchanged(286+/-81% at hyperemia baseline, 296+/-91% at 100 beats/min, 289+/-105% at 120 beats/min, p>0.05). Systolic CFVI/min was increased at baseline(185+/-35% at 120 beats/min, p<0.01) and in adenosine hyperemia(377+/-153% at hyperemia baseline, 457+/-178% at 120 beats/min, p=0.01). Diastolic CFVI/min was increased at baseline(134+/-178% at 120 beats/min, p<0.01), but in adenosine hyperemia, no significant change was observed(278+/-77% at hyperemia baseline and 251+/-77% at 120 beats/min, p>0.05). CONCLUSION: Increase in heart rate induces a substantial reduction in maximal CFR. Thus,heart rate appears to be one of important variable for the measurement of CFR and phasin coronary flow profile.
Adenosine ; Arteries ; Chest Pain ; Coronary Vessels ; Female ; Heart Rate* ; Heart* ; Hemodynamics ; Humans ; Hyperemia ; Male

Pedicled omentoplasty is effective in thoracic surgery, but it is associated with several postoperative complications. A case of diaphragmatic hernia as a complication of pedicled omentoplasty in a 65-year-old male is reported. Because aortoesophageal fistula occurred three months after the patch aortoplasty for mycotic aneurysm of descending thoracic aorta, he underwent ascending thoracic aorta to abdominal aorta bypass surgery with resection of thoracic aortic aneurysm and esophagorrhaphy with wrapping of the esophageal suture line and the stumps of aorta with pedicled omental flap. Three years after the operation, herniation of the stomach developed. The pedicled omental flap was ligated and divided, and the diaphragm defect was repaired.
Aged ; Aneurysm, Infected ; Aorta ; Aorta, Abdominal ; Aorta, Thoracic ; Aortic Aneurysm, Thoracic ; Diaphragm ; Fistula ; Hernia, Diaphragmatic* ; Humans ; Male ; Postoperative Complications ; Stomach ; Surgical Flaps ; Sutures ; Thoracic Surgery

No abstract available.
Arteriovenous Fistula* ; Renal Dialysis*

Aortoesophageal fistula is an uncommon and fatal complication after surgery of aortic aneurysm. A case of aortoesophageal fistula as a complication of synthetis patch aortoplasty for mycotic aneurysm of descending thoracic aorta is described. After 3 months since patch aortoplasty for mycotic aneurysm of descending thoracic aorta this patient visited the emergency room due to melena and hematemesis. After gastrofiberoscopy and computed tomography the patient was taken ot the operating room. The surgical intervention was performed in two steps. Median sternotomy and midline laparotomy were made. Hemashield's Dacron(16mm) bypass between ascending thoracic aorta and infra-renal abdominal aorta was established first. Through the posterolateral thoracotomy false aneurysm and previous Hemashield's Dacron patch of descending aorta were resected. The two ends of the aorta were sutured and esophageal fistula was repaired. The esophageal suture line and the stumps were covered with omental graft. Thirty months later the patient has had no difficulty referable to the aortic surgery.
Aneurysm, False ; Aneurysm, Infected* ; Aorta ; Aorta, Abdominal ; Aorta, Thoracic* ; Aortic Aneurysm ; Emergency Service, Hospital ; Esophageal Fistula ; Fistula* ; Hematemesis ; Humans ; Laparotomy ; Melena ; Operating Rooms ; Polyethylene Terephthalates ; Sternotomy ; Sutures ; Thoracotomy ; Transplants

Mediastinal parathyroid cyst is a very rare disease and is usually found incidentally. Surgical excision is the treatment of choice and recurrence is very rare when complete excision is done. A 71-year-old man was referred to our department because of 6x5cm sized right superior mediastinal mass found incidentally on chest X-ray. Surgical excision was performed and pathologic findings were confirmed as mediastinal parathyroid cyst. The patient has been followed up postoperatively without recurrence for 4 months up to now. We report a case of mediastinal parathyroid cyst.
Aged ; Humans ; Mediastinal Cyst ; Parathyroid Glands ; Parathyroid Neoplasms ; Rare Diseases ; Recurrence ; Thorax