From September 1992 to April 1994, we reviewed 7 patients after arthroscopic surgery for anterior impingement in the ankle, who complained ankle pain and limitation of motion. All patients were mem and main symptoms were severe pain at full dorsiflexion of ankle and limitation of motion. Bony spur was located on the anterior aspect of tibia, and it was possible to resect the tibial bony spur arthroscopically without distraction devices. Mean operation time was 55 minutes. Pain, swelling and limitation of motion were much improved. There was no postoperative complication. Arthroscopic resection of the anterior tibial bony spur is an effective treatment for anterior impingement in the ankle.
Ankle ; Arthroscopy ; Humans ; Postoperative Complications ; Tibia

Lipoma arborescens is a rare intra-articular lesion consisting of a villous lipomatous proliferation of the synovial lining. We experienced one case of lipoma arborescens of knee which was associated with avascular necrosis of femoral head. This case report draws the attention to history, physical findings, MR images, pathologic findings and arthroscopic appearance of this rare lesion. Arthro;copically, the lesion appears as a synovial lesion with numerous fatty-appearing globules and villous projections. Although the etiology is unknown, lipoma arborescens has been described in association with osteoarthritis, rheumatoid arthritis and diabetes mellitus. MR imaging is diagnostic choice to differentiate the lesion from rheumatoid arthritis, pigmented villonodular synovitis and synovial chondromatosis in those patients who present with chronic, swollen and painfui joint. Arthroscopic removal was effective in this case and we think that treatment choice of this lesion is arthroscopic removal.
Arthritis, Rheumatoid ; Chondromatosis, Synovial ; Diabetes Mellitus ; Head ; Humans ; Joints ; Knee* ; Lipoma* ; Magnetic Resonance Imaging ; Necrosis ; Osteoarthritis ; Synovitis, Pigmented Villonodular

PURPOSE: To evaluate further the right minor and major fissure on thin-section narrow-interval CT scans with particular emphases on orientation, degree of completeness. MATERIALS AND METHODS: Thin section CT scans from 10 mm distal to carina to the proximal basal segmental bronchus were obtained at 5 mm invervals in 50 consectutive subjects. Orientation, degree of completeness, and the relationship of the minor and major fissure on thin-section CTscans were analyzed. RESULTS: Four principal types of the minor fissure could be identified according to the highest point of the upper surface of the middle lobe. At bronchus intermedius level, the major fissure appeared with its medial end anterior to lateral end in 45 subjects. The minor fissure was complete in only 10 subjects (20%). Completely absent minor fissure was noted in four subjects (8%). The major fissure was incomplete in 17 subjects (34%) at bronchus intermedius level. the minor and major fissure intersected each other in only 27 subjects (54%). The hig best point of intersection was variable. CONCLUSION: There are much more variations in the fissural complex in our study than in previous reports and these variations can be visualized well on thin-section CTscans.
Bronchi ; Lung* ; Tomography, X-Ray Computed*

Agenesis of the dorsal pancreas is one of the rare congenital anomalies of the pancreas. Six cases of them have been reported. We have experienced an autopsy case of agenesis of the dorsal pancreas associated with fetal death in the uterus. Grossly, the body and tail of the pancreas and uncinate process were not found and those were partially replaced by adipose tissue. No abnormality was noted in the other organs. Microscopically, pancreatic tissue with autolytic change was identified only in the head portion of the pancreas.

The CT findings were reviewed in two patients with injuries to the gallbladder following blunt trauma. In one patient high attenuation of intraluminal blood clot within the gallbladder and associated hemoperitoneum were identified. Another patient was represented hemoperitoneum and bile leakage into the peritoneal cavity due to laceration of the fundus of the gallbladder which appeared contrasted.
Bile ; Gallbladder ; Hemoperitoneum ; Humans ; Lacerations ; Peritoneal Cavity

A 10-year-old boy had a recurrence of cutaneous lesions 1 week after only one exposure to jellyfish on the lower extremity. The recurring lesion was charaeterized by pruritic several linear or whiplash-like erythematous and some edematous papuloplaques. The histopathologic findings showed focal hyperkeratosis, acanthosis in epidermis and mild perivascular infiltration of inflammatory cells, capillary proliferations in dermis.
Capillaries ; Child ; Dermis ; Epidermis ; Humans ; Lower Extremity ; Male ; Recurrence

We performed an epidemiologic survey to investigate the dermatologic problems from cutting oils in metal workers. The personal questionnaires and dermatologic examinations were performed on 360 metal workers who were working at 50 metal industries. The pH meter (HANNA 8520) and the atomic absorption spectrometer(G.B.C. 902) were employed to measure the pH values of cutting oil and the concentration of heavy metals contained in cutting oil respeetively. The results were as follows : 1. The prevalence rates of the dermatologic disorders from cutting oil were 46.0% of eontact dermatitis, 10.9% of black comedone, and 7.1% of paronychia in orders. The dermatologic disorders that seemed to be not directly associsted with cutting oil were callosity(19.1%), burn by metal chips(9.8%), and mechanical injury(5.7%). 2. The localizations of the contact dermatitis and the black cemedone from cutting oil were 84% of hands, 6.6% of face, and 5% af forearms. More detailed localizations of the contact dermatitis and black comedone that developed in hand were 29.6% if finger tip, 27.6% of palm and palm finger, and 19.1% of palm finger only in orders. 3. The prevalence rates of the dermatologic disorders by the of cutting oil were 51.5% of soluble oil, 68.8% of insoluble oil, and 80.8% of mixed cutting oil which containing both soluble and insoluble oil. 4. The mean pH value of aoluble cutting oil was 8.0 and that of insoluble cutting oil was 7.0. 5. The concentrations of heavy metals contained in soluble oil were 32.2 mg/m3 of chrome, 6.42 mg/m3 of nickel, and 4.85 mg/m3 of cobalt. The concentrations of heavy metals contained in inspluble oil were 24.11 mg/m of chrome, 4.63 mg/m3 of nickel, and 2.30 mg/m3 of cobalt.
Absorption ; Burns ; Cobalt ; Dermatitis ; Dermatitis, Contact ; Epidemiologic Studies* ; Fingers ; Forearm ; Hand ; Humans ; Hydrogen-Ion Concentration ; Metals, Heavy ; Nickel ; Oils ; Paronychia ; Prevalence ; Surveys and Questionnaires

Cytophagic histiocytic panniculitis(CHP) is a histiocytic disorder that was first described by Winkelmann and Crotty in 1980. We have recently experienced a case of CHP is a 21-year-old female who had developed recurrent fever and erythematous tender subcutaneous nodules, progressing to liver dysfunction and hemorrhagic diathesis. Histopathologically, infiltrates of large cytophagic histiocytes lacking atypia were present in the subcutis. Hemophagocytic histiocytes were observed in the bone marrow. Immunohistochemical studies were performed, and revealed positive immunoreactivity for lysozyme and T cell marker in the subcutaneous inflammatory lesions.
Bone Marrow ; Female ; Fever ; Hemorrhagic Disorders ; Histiocytes ; Humans ; Liver Diseases ; Muramidase ; Panniculitis* ; Young Adult

We examined 60 eyes of 60 patients after excimer photorefractive keratectomy(PRK) for myopia and analyzed the changes of central island on corneal topography for 6 months prospectively. These patients were divided into two groups according to the degree of myopia, group 1(26 eyes, 6 diopters or below by spherical equivalent) and group 2 (34 eyes, over 6 diopters). The occurrence rate of central island was 76.4% collectively, 87.5% in group 1, 67.7% in group 2 at 2 weeks after PRK. It decreased to 30.4%, 43.5%, and 21.1% respectively at 6 months after PRK and was lower in group 2 than group 1. However there was no statistically significant correlation between the reduction of central island size and improvement of corrected visual acuity in both groups. In conclusion, the central island disappeared and decreased the amount for six months follow-up period after PRK and seems to be no effect on the corrected visual acuity.
Corneal Topography ; Follow-Up Studies ; Humans ; Myopia* ; Photorefractive Keratectomy* ; Prospective Studies ; Visual Acuity*

BACKGROUND: In the most of emergency department, the diagnosis of appendicitis has been carried by clinical history, physical examination and plain X-ray. But the diagnostic accuracy by these methods was so low that unnecessary operation was common performed, and sometimes the operation was delayed till the physicians could confirm the acute appendicitis clinically. Although many kinds of diagnostic tools such as CT scan, laparoscope, and etc, we believe that ultrasonography(US) would be a quick and sensitive diagnostic method for the evaluation of acute appendicitis in the Emergency Department. METHODS: Forty-seven patients who were clinically suspected as acute appendicitis were evaluated with the grayscaled US by emergency physician. The probe of US was placed on maximal tender point of abdomen, and the appendix image was evaluated while probe was pressed deeply and gentry. When the blind loop was fecund at maximal tender point of abdomen, we evaluated the diameter of appendix, the presence of compressibility, peri-aspen-diceal fluid collection and other mass effect. As soon as the ultrasonographic evidences of the appendicitis were noticed, the operations were done and pathologic report were reviewed later. RESULTS: Among the forty-seven patients, forty patients were diagnosed as a appendicitis by US, and most common ultrasonic findings were as follows; 1) non-compressible blind loop larger than 5 mm in diameter, 2) wall thickening more than 3 mm, 3) peri-appendiceal fluid collection, 4) periappendiceal mass. Among remaining 7 patients in whom we could not get any positive findings of appendicitis, abdominal CT scan was carried in 2 cases who had direct and rebound tenderness on right lower abdomen, and CT scan showed the evidences of the appendicitis. The other 5 cases without rebound tenderness were observed far 2 hours, and abdominal pain was disappeared lately. Finally forty-two patients were operated and confirmed as acute appendicitis by pathologic reports; 24 were reported as suppurative appendicitis, and 12 cases of gangrenous appendicitis, 3 cases of perforated appendicitis, and 3 cases were peri-appendiceal abscess. The specificity of US in the diagnosis of acute appendicitis was 71.4%, and the sensitivity was 95.2%. CONCLUSIONS : In some patients suspected appendicitis, emergency physicians could diagnosis acute appendicitis accurately and rapidly by use of ultrasonography. Although the US was an actuate imaging modality to diagnosis acute appendicitis and evaluate its complications, we recommend a laparotomy or abdominal Cf scan in the patients with negative US findings in spite of presence of peritoneal irritation signs such as rebound tenderness and/or muscle guarding on right lower abdomen.
Abdomen ; Abdominal Pain ; Abscess ; Appendicitis* ; Appendix ; Diagnosis ; Early Diagnosis* ; Emergencies* ; Emergency Service, Hospital* ; Humans ; Laparoscopes ; Laparotomy ; Physical Examination ; Sensitivity and Specificity ; Tomography, X-Ray Computed ; Ultrasonics ; Ultrasonography*