The widespread use of diagnostic radiography, especially using magnetic resonance imaging, has helped to increase the diagnosis of paralabral cysts in patients with chronic shoulder pain. These paralabral cysts are frequent in the anterior, the superior, and the posterior compartment of the shoulder joint but are rare in the inferior compartment. Paralabral cysts in the shoulder appear particularly in men in their third and fourth decades but rarely in elderly patients. We report a case of an inferior paralabral cyst in an elderly patient whom we treated through arthroscopic decompression.
Aged* ; Arthroscopy ; Decompression* ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Male ; Radiography ; Shoulder Joint ; Shoulder Pain ; Shoulder*

No abstract available.
Cesarean Section* ; Female ; Pregnancy

Gout often occurs in the first metatarsophalyngeal joint, and also in the ankle joint and posterior foot. Knee joint gouty arthritis is commonly reported, but gouty tophi in bilateral popliteal cysts, such as this case, are rare. We report on a case treated by cystectomy of gouty tophi in bilateral popliteal cysts and review.
Ankle Joint ; Arthritis, Gouty ; Cystectomy ; Foot ; Gout ; Joints ; Knee ; Knee Joint ; Popliteal Cyst*

PURPOSE: Cementless total hip arthroplasty was performed to treat primary osteoarthritis of the hip and avascular necrosis of the femoral head. The clinical and radiological results of the acetabular cups and femoral stems were compared. MATERIALS AND METHODS: The subjects were 84 cases who underwent primary cementless total hip arthroplasty from March 1992 to May 2001. The 84 cases were followed up for at least eight years. The patients were divided into the following two groups: group (A), 38 cases of degenerative osteoarthritis of the hip; and group (B), 46 cases of avascular necrosis of the hip. The clinical evaluation was conducted based on the Harris Hip Score (HHS). A radiological assessment was performed to determine if osteolysis or acetabular loosening had occurred. The results were analyzed statistically. RESULTS: The postoperative HHS of groups A and B at the final follow-up were 92.1 and 91.2, respectively (p=0.483). The radiological results revealed 9 and 15 cases of acetabular osteolysis (p=0.671) and 1 and 3 cases of vertical migration of the acetabular cups in the group A and B, respectively. Eight and 7 complications (p=0.572) were encountered in group A and B, respectively. Among these, 4 and 5 cases of revisional total hip arthroplasty were performed in group A and B, respectively. The results of survival analysis were similar in the two groups (p=0.969). CONCLUSION: The clinical and radiological features of the acetabular cups and stems were similar in the two groups. Nevertheless, further studies will be needed due to the high rate of polyethylene liner wear and osteolysis around the acetabular cups or femoral stems.
Arthroplasty ; Follow-Up Studies ; Head ; Hip ; Humans ; Necrosis ; Osteoarthritis ; Osteolysis ; Osteonecrosis ; Polyethylene

Malignant fibrous histiocytoma is uncommon pleomorphic tumor of the soft tissue possibly arising from the histiocyte. We report on a 43-year-old man with malignant fibrous histocystoma of the right kidney. The chief complaint was nontender mass on the right flank, which recurred locally following radical nephrectomy and postoperative radiation.
Adult ; Histiocytes ; Histiocytoma ; Histiocytoma, Malignant Fibrous* ; Humans ; Kidney* ; Nephrectomy

Perimembranous ventricular septal defects(PMVSDs) are the most common type of ventricular septal defects(VSDs) and consist morphologically of deficiency of the membranous septum and variable portions of the adjacent muscular septum. Repair of VSD has begun via a right ventriculotomy. Even with this exposure, however, it mght lead to ventricular dysfunction. Transatrial exposure of VSDs is known to a versatile approach to PMVSDs and even malalignment defects can be repaired by this METHOD: Although transatrial exposure can be improved by taking down the atrioventricular valve at the annulus, surgeons have been hesitant to do so because of concern for valvular competence. Therefore, this study was undertaken to clarity the effects of transannular approach of tricuspid valve (TATV) at operation of PMVSD. During last 5 years, twenty eight cases from 96 patients of PMVSD were closed by TATV and follow up study was done from 3 months to 33 months and results were obtained as follows. 1. Age at operation was from 4 months to 38 years and most patients(17, 62%) were above 5 years. 2. Preoperative pulmonary-systemic flow ratio(Qp/Qs) was ranged from 1 to 2.8 and 22 patients(79%) were less than 2. 3. Peak systolic pulmonary artery pressure was below 30mmHg in 8, 30-50mmHg in 17, above 50mmHg in 3 patients and 25 patients(89%) were less than 50mmHg. 4. Preoperative tricuspid regurgitation(TR) is none in 12, trivial in 6, mild in 3, moderate in 5, severe in 2 patients but postoperative TR was none in 18, trivial in 6, mild in 4 patients, so TR in most patients had decreased or not. 5. Indications for operation were based on the presence of a significant shunt. However, in patients with small shunts, indications for operation were included additional factors, tricuspid valve pouch, RVOT obstruction(right ventricular outflow tract obstruction), subacute bacterial endocarditis and associated anomalies. 6. There were no hospital deaths and residual shunts in postoperative echocardiography. Therefore, TATV is especially a good method in PMVSD where patients have trcuspid valve pouch. And it is a safe and effective technique that improves exposure for PMVSD repair and does not adversely affect tricuspid valvular competence.
Echocardiography ; Endocarditis, Subacute Bacterial ; Follow-Up Studies ; Humans ; Mental Competency ; Pulmonary Artery ; Tricuspid Valve ; Ventricular Dysfunction

Undifferentiated pleomorphic sarcoma of the breast are uncommon and often present diagnostic challenges. Herein, we report a case of the undifferentiated pleomorphic sarcoma occurring in the male breast. A 76-year-old man presented with a palpable bean-sized mass in his left breast for two months. Core needle biopsy revealed the presence of atypical cells in a fibrous proliferative lesion, which was removed by wide excision. Based on examination of the excised tumor, the initial pathologic diagnosis was atypical spindle cell lesion with uncertain malignant potential. One year later, the patient returned with a recurrent mass atthe previous surgical site. The mass was again surgically removed using wide excision. Based on histological findings with immunomarkers, the final diagnosis was undifferentiated pleomorphic sarcoma. Undifferentiated pleomorphic sarcoma of the breast can cause genuine diagnostic difficulty and appropriate immunohistochemistry is mandatory for differential diagnosis.
Aged ; Biopsy, Large-Core Needle ; Breast ; Breast Neoplasms ; Diagnosis, Differential ; Histiocytoma, Malignant Fibrous ; Humans ; Immunohistochemistry ; Male ; Sarcoma

Bartter syndrome is characterized by markedly reduced or absent salt transport by the thick ascending limb of Henle. The phenotype of Bartter syndrome is renal salt wasting, hypokalemic metabolic alkalosis, increased renin-angiotensin-aldosterone system, with normal or low blood pressure. Most of the cases have been noted in the pediatric age group and adult-onset cases are rare. Nephrocalcinosis is common in antenatal Bartter syndrome. We report a case of adult-onset Bartter syndrome associated with nephrocalcinosis.
Alkalosis ; Bartter Syndrome* ; Extremities ; Humans ; Hypokalemia ; Hypotension ; Nephrocalcinosis* ; Phenotype ; Renin-Angiotensin System

A preliminary study was performed to investigate the staining characteristics of trabecula. endothelial cells with low density lipoprotein (LDL) and acetylated low density lipoprotein (Ac-LDL) labeled with a fluorescent probe, 1, 1`- dioctadecyl-3,3,3`, 3`- tetramethyl-indocarbocyanine perchlorate (Dil). Trabecular endothelial cells revealed a strong fluorescence with Dil-LDL, which was contradictory to the previous results obtained from other types of endothelial cells. These cells also showed a moderate fluorescence with Dil-Ac-LDL. Scleral fibroblasts and keratocytes showed a moderate to strong fluorescence with Dil-LDL and a weak fluorescence with Dil-Ac-LDL. Corneal endothelial cells revealed a very weak background fluorescence with Dil-LDL and a moderate fluorescence with Dil-Ar-LDL. Therefore, these four kinds of cells could not be definitely differentiated depending only on the staining characteristics with Dil-LDL and Dil-Ac-LDt.
Animals ; Cattle ; Endothelium/cytology ; Fluorescent Dyes/*diagnostic use ; Lipoproteins, LDL/*metabolism ; Trabecular Meshwork/*metabolism

Twenty-three patients underwent operations to repair a congenital heart disease through right anterolateral thoracotomy(RALT) between December 1989 and December 1996. Defects repaired 22 atrial septum(13 ostium secundum;3 lower sepal defect;4 posterior septal defect;1 sinus venosus;1 ostium primum) and 1 ventricular septal defect. There was no operative mortality or late morbidity directly related to RALT. The RALT incision is a safe and effective method to a median sternotomy in selective patients(especicially female). The cosmetic results are very good during the follow up periods.
Follow-Up Studies ; Heart Defects, Congenital ; Heart Septal Defects, Ventricular ; Humans ; Mortality ; Sternotomy ; Thoracic Surgery* ; Thoracotomy*