No abstract available.
Autografts ; Goldenhar Syndrome

Compared with osteosarcoma of bone, primary osteosarcoma of the soft tissue is very rare. Extraskeletal osteosarcoma is also a highly malignant pleomorphic sarcoma composed of cells exhibiting primarily osteoblastic, and to a lesser extent, chondroblastic differentiation. A case of extraskeletal osteosarcoma in the right sole is presented in a 67 year old male. The patient had noticed a progressively enlarging soft tissue mass, during about 14 months. This sarcoma was located in the soft tissues without attachment to the skeleton, as determined by examination of the X-Ray findings. The mass of right plantar portion was simply excised and pathologically confirmed to be an extraskeletal osteosarcoma. The clinical and pathological features of this sarcoma are described, and brief review of the literature is made.

Crescentic glomerulonephritis in rheumatoid arthritis is described recently with increasing frequency. It can occur directly as a manifestation of rheumatoid arthritis or may be a reaction to drugs such as D-penicillamine and bucillamine. We report a case of crescentic glomerulonephritis in a 46-year-old woman with rheumatoid arthritis for 20 years who had been treated intermittently with herb medicine or nonsteroidal anti-inflammatory drugs (NSAIDS). Light microscopic examination showed severe focal segmental and global necrotizing glomerulonephritis with crescent formation in 50% of the glomeruli. Immunofluorescent study revealed scanty amount of mesangial granular deposits of IgA, IgM, C3 and fibrinogen in a diffuse pattern.
Female ; Humans

OBJECTIVES: The aims of this study were to know the prevalence of cognitive disorders in patients with thyroid cancer, and identify related variables to them. METHODS: Subjects were consisted of fourty-two patients with thyroid cancer, who were admitted for radioiodine ablative therapy at 6-12 months after total thyroidectomy. The data were obtained from interviews about history and assessments of depression and cognitive function(Korean Version of the Montreal Cognitive Assessment, MoCA-K). RESULTS: 1) Among subjects, those with below 22 of total score of the MoCA-K were twenty-one(50.0%). 2) Upon age, education, Pre-radioiodine therapy thyroid stimulating hormone(TSH), there were statistically significant difference between subgroup with above 23 of the total MoCA-K score and those below 22. 3) The total scores of the MoCA-K in subjects had significant correlation with age, education, comorbidity, Pre-radioiodine therapy TSH, total score of the HDRS-17. CONCLUSIONS: Cognitive disorders were more prevalent among patients with thyroid cancer before radioiodine therapy. Therefore, further study should be needed to clarify the mechanism for the cognitive disorders in thyroid cancer. Furthermore, physicians should pay attention to the cognitive function and prepare preventative measures for cognitive disorder during management of thyroid cancer.
Carcinoma, Papillary* ; Comorbidity ; Depression ; Education ; Humans ; Prevalence ; Thyroid Gland* ; Thyroid Neoplasms ; Thyroidectomy ; Thyrotropin

Scapholunate advanced collapse (SLAC) deformity most often occurs with chronic rotary scaphoid instability from scaphoiunate ligament tear and scaphoid fracture. Prior to 1984 when Watson HK reported his concept on SLAC wrist deformity, the most popular procedure for this pathology was scaphoid implant arthroplasty with or without midcarpal fusion. We have reviewed 15 cases of SLAC deformity treated with scaphoid excision and midcarpal fusion from 1984 to 1993. Among them, scaphoid implants made of silicone were inserted in 4 cases. Scaphoid implant arthroplsty without carpal fusion has been excluded. The mean period of follow-up was 8.8 years and the mean age of patients was 47.5 years. Males and right wrists were predominant. Wrist motion was 56% and grip power was 71% of the normal opposite side. On the average overall, 8 patients had no pain and 7 patients had mild pain. The grade of pain was minimal, 0.5 in grade (Rating system: no pain-0, mild- 1, moderate-2, severe-3). However, all of the 4 cases of limited carpal fusion with a scaphoid implant developed silicone particulate induced synovitis and pain. The procedure appears to be effective in maintaining function of the hand with minimal pain up to 5.8 years. However, silicone scaphoid implant appears not to be necessary and is not recommended with a limited carpal fusion for this pathology.
Arthroplasty ; Congenital Abnormalities ; Follow-Up Studies ; Hand ; Hand Strength ; Humans ; Ligaments ; Male ; Pathology ; Silicones ; Synovitis ; Wrist

No abstract available.
Child ; Femoral Fractures ; Humans

Insufficiency fracture of the calcaneus is a rare entity. In the absence of trauma, evaluating a painful ankle in an elderly patient can be difficult and also it might be overlook the insufficiency fracture. We experienced a case of insufficiency calcaneus fracture that occurred after ipsilateral total knee arthroplasty. Here, we report our case with a review of literatures.
Aged ; Ankle ; Arthroplasty* ; Calcaneus ; Fractures, Stress* ; Humans ; Knee*

BACKGROUND: Motor conduction slowing in diabetic distal symmetrical polyneuropathy (DSP) generally exceeds that in distal axonal polyneuropathy. Additional mechanisms secondary to axonal injury may contribute towards this slowing. However, clinical and pathophysiological significances of motor conduction slowing have been rarely discussed. The purpose of this study is to evaluate the clinical and pathophysiological significance of conduction slowing in DSP. METHODS: We analyzed motor conduction studies of 39 patients with symptomatic painful DSP and 24 patients with asymptomatic painless DSP. Motor conduction studies of 39 patients with amyotrophic lateral sclerosis (ALS) were used as controls for the amplitude-dependent slowing of conduction. Percentages of normal limits were calculated for the compound muscle action potential amplitude (CMAP), distal motor latency (DL), and conduction velocity (CV), and converted to a square root (SQRT) form. The changes of SQRT-DL or SQRT-CV according to SQRT-CMAP changes were plotted and analyzed. RESULTS: Regression analysis showed that DL and CV were amplitude-dependent in both painless DSP and ALS. The changes of DL and CV in painful DSP did not show amplitude-dependency except DL in the lower extremities. CONCLUSIONS: This data supports the hypothesis that the mechanism of slowing is similar in both painless DSP and ALS and results from the loss of large, fast-conducting fibers. Lack of amplitude-dependency of conduction slowing in painful DSP may reflect the combined axonal and demyelinating changes, possibly due to inflammation.
Action Potentials ; Amyotrophic Lateral Sclerosis ; Axons ; Diabetic Neuropathies* ; Electrophysiology ; Humans ; Inflammation ; Lower Extremity ; Neural Conduction ; Polyneuropathies

BACKGROUND: The video-assisted thoracic surgery (VATS) with 2 mm thoracoscopy in primary spontaneous pneumothorax (PSP) was known to be unreliable in its accuracy and recurrence rate. We compared 10 mm VATS with 2 mm VATS in the results of operation. MATERIAL AND METHOD: From Sept. 1998 to Dec. 2002, 176 cases (10 mm VATS; 73 cases, 2 mm VATS; 103 cases) of PSP were treated by VATS bleb resection at Korea University Ansan Hospital. 10 mm thoracoscope, 5 mm port, and 5 mm instruments were used in 10 mm VATS group, and 2 mm thoracoscope, 2 mm ports and 2 mm instruments used in 2 mm VATS group. In the two groups, staples were inserted through 11.5 mm port for chest tube. RESULT: The mean follow-up duration was 20.8+/-16.1 months in 10 mm VATS group, and 13.9+/-8.2 months in 2 mm VATS. The most common indication of operation was a recurrent pneumothorax (34%) in 10 mm VATS and patient's desire (40%) in 2 mm VATS, respectively. The operation time, number of staples used in operation, postoperative chest tube keeping days, postoperative total amount of drainage, and postoperative hospitalization days were statistically lower in 2 mm VATS. Other significant variables affecting the operation time in linear regression analysis were the number of staples that used in operation, the presence of pleural adhesion, and type of pleurodesis and thoracoscope used in operation. However, R2 values were lower than 0.1. The postoperative recurrence rate was 2.7% in 10 mm VATS and 2.9% in 2 mm VATS. It was not significant statistically. Recurrent cases developed within 1 year in both groups but the difference was statistically insignificant. CONCLUSION: Although there were differences in follow-up duration between two groups, the operation time, number of staples that used in operation, postoperative chest tube keeping days, postoperative total amount of drainage, and postoperative hospitalization days were statistically lower in 2 mm VATS. And in 2 mm VATS, there were no technical difficulties during operation and no differences in recurrence rate from 10 mm VATS. As a result, we suggest that 2 mm VATS can be used in the treatment of PSP.
Blister ; Chest Tubes ; Drainage ; Follow-Up Studies ; Gyeonggi-do ; Hospitalization ; Korea ; Linear Models ; Pleurodesis ; Pneumothorax* ; Recurrence ; Thoracic Surgery, Video-Assisted* ; Thoracoscopes ; Thoracoscopy*