The giant intra-articular osteochondroma of the knee is very rare and is probably result of synovial metaplasia of the fibrous capsule or of the adjacent connencive tissue of a joint, and of the fragment of articular cartilage. The gross findings and histology are consistent with the osteochondroma. The authors experienced a case of giant intra-articular osteochondroma of the right knee in a 19 years old man who had history of knee injury when he was 16 years old. The mass was excised and the symptome was relieved.
Cartilage, Articular ; Joints ; Knee Injuries ; Knee ; Metaplasia ; Osteochondroma

Seventy-seven patients who were treated regularly for more than 5 years in the Taegu Leprosy Mission were investigated with regard to the change of the bacillary index(BI) after treatment of either dapsone(DDS) alone or a combination of DDS and clofazimine. The results were as follows: 1) In the group that took only DDS 400-500 mg per week, the BI conversion to negative took average 51 months. 2) In the group that took only 600-700 mg per week, the BI conversion to negative took average 34 months. 3) In the group that took only DDS 400 mg per week initially and 600-700mg per week secondarily, the BI conversion to negative took average 64 months, the last 33 months of which marked the time period that 600-700 mg were taken per week. 4) In the group that took only DDS 400-500mg per week initially and a combination of DDS gpp 700 mg per week and clofazimine. 3pp-4pp mg per week secondarily, the BI conversion to negative took average 63 months, the last 35 months of which marked the time period for the combined therapy. 5) In the group that took a combination of DDS 600- 700 mg per week and clofazimine 400 mg per week, the BI conversion to negative took average 42 months.
Clofazimine* ; Daegu ; Dapsone* ; Humans ; Leprosy* ; Missions and Missionaries

No abstract available.
Achilles Tendon* ; Xanthomatosis*

PURPOSE: Inferior blow-out fracture is the common facial fracture. Unsatisfactory functional and aesthetic outcomes are frequent when it is treated inappropriately. If fractures are extended and reach the posterior end of orbital floor, enophthalmos frequently followed as complication. The PURPOSE of this study was to evaluate reduction technique of extensive inferior blow-out fracture with ballooning of foley catheter through endoscopic transnasal approach and implantation of Medpor(R) through subciliary approach. METHODS: A retrospective study was performed on 14 patients with extensive inferior blow-out fracture who underwent ballooning of foley catheter through endoscopic transnasal approach with implantation of Medpor(R) through subciliary approach. Patients were operated from May 2005 to November 2007. Data for 14 patients were acquired from patient's charts. Preoperative and postoperative data for enophthalmos, diplopia, limitation of extraocular motion were reviewed. Preoperative and postoperative CT scan were also checked. The patients were followed up from 4 to 18 months. RESULTS: The enophthalmos was corrected in all patients. Among 7 patients with diplopia preoperatively, diplopia was resolved in three patients postoperatively. The diplopia persisted in four patients and two of them also had limitation of extraocular motion postoperatively. The limitation of extraocular motion occurred in seven patients preoperatively. But five patients recovered after operation immediately. These symptoms were resolved about three months after the operation. CONCLUSION: The ballooning of foley catheter through endoscopic transnasal approach with implantation of Medpor(R) through subciliary approach can be considered one of the appropriate technique for extensive inferior blow- out fracture.
Catheters ; Diplopia ; Enophthalmos ; Floors and Floorcoverings ; Humans ; Orbit ; Orbital Fractures ; Retrospective Studies

PURPOSE: Inferior blow-out fracture is the common facial fracture. Unsatisfactory functional and aesthetic outcomes are frequent when it is treated inappropriately. If fractures are extended and reach the posterior end of orbital floor, enophthalmos frequently followed as complication. The PURPOSE of this study was to evaluate reduction technique of extensive inferior blow-out fracture with ballooning of foley catheter through endoscopic transnasal approach and implantation of Medpor(R) through subciliary approach. METHODS: A retrospective study was performed on 14 patients with extensive inferior blow-out fracture who underwent ballooning of foley catheter through endoscopic transnasal approach with implantation of Medpor(R) through subciliary approach. Patients were operated from May 2005 to November 2007. Data for 14 patients were acquired from patient's charts. Preoperative and postoperative data for enophthalmos, diplopia, limitation of extraocular motion were reviewed. Preoperative and postoperative CT scan were also checked. The patients were followed up from 4 to 18 months. RESULTS: The enophthalmos was corrected in all patients. Among 7 patients with diplopia preoperatively, diplopia was resolved in three patients postoperatively. The diplopia persisted in four patients and two of them also had limitation of extraocular motion postoperatively. The limitation of extraocular motion occurred in seven patients preoperatively. But five patients recovered after operation immediately. These symptoms were resolved about three months after the operation. CONCLUSION: The ballooning of foley catheter through endoscopic transnasal approach with implantation of Medpor(R) through subciliary approach can be considered one of the appropriate technique for extensive inferior blow- out fracture.
Catheters ; Diplopia ; Enophthalmos ; Floors and Floorcoverings ; Humans ; Orbit ; Orbital Fractures ; Retrospective Studies

With the recent development in microsurgery, the use of a perforator flap has been widely implemented. If the length of the ALT flap pedicle is insufficient despite adequate preoperative planning, pedicle length extension is necessary. We planned for a reverse ALT free flap using the distal vessel of the descending branch for pedicle length extension in the case of ALT perforator branch originating from the proximal portion of the descending branch. For the management of venous congestion, the distal venae comitantes were anastomosed to the proximal venous stump in an antegrade manner, successfully resolving the venous congestion. Modified reverse-flow ALT free flap, wherein the venae comitantes are anastomosed to the proximal vein stump, is a good option that allows for relatively simple pedicle extension within the same operative field when securing an adequate pedicle length is difficult because of the origin of the perforator from the proximal descending branch, unlike the initial surgical plan.
Free Tissue Flaps ; Hyperemia ; Lower Extremity ; Microsurgery ; Perforator Flap ; Surgical Flaps ; Thigh ; Veins

Notch stenosis had been thought to be related with anterior cruciate ligament (ACL) injury. The purpose of this study is to evaluate the possible relationship between notch stenosis and ACL injury. We measured the notch seen on the axial section in MRI at popliteal groove. We have retrospectively analyzed 116 cases of knee MRI. All cases were divided into three groups ; Group I were fifty six normal knee. Group II were thirty knee with contact ACL injuries. Group III were thirty knee with non contact ACL injuries. The result were as follows; 1. Statistically significant difference was found in the notch width index (NWI) between group I and group III but no significant differences was found in the NWI between group I and group II. 2. Statistically significant correlation to non-contact ACL injuries was found in the NWI at both anterior and posterior outlet of the notch. 3. An unique shape of the notch was found in the majority of group III.There seemed to be an obvious relationship between notch stenosis and non-contact ACL injuries.
Anterior Cruciate Ligament* ; Constriction, Pathologic ; Knee ; Magnetic Resonance Imaging* ; Retrospective Studies

Objective: . Although gout is the most common form of inflammatory arthritis, data on gout prevalence and management are sparse, especially in Korean populations. This study reevaluated the most recent prevalence and incidence of gout values in Korean people to update the findings from our previous study in 2011. Methods: . We used the National Health Insurance Service-National Health Information Database (NHIS-NHID) to identify patients diagnosed with gout in South Korea during 2002∼2015. We selected patients with gout as principal diagnosis or 1st∼4th additional diagnosis. Results: . The prevalence of gout increased 5.17-fold, from 0.39% in 2002 to 2.01% in 2015. This increase occurred in all age groups, but was stronger in those aged 80 years or older, with a 13.1-fold increase from 2002 to 2015. The prevalence of gout increased in all regions of South Korea. The prevalence of the disease was also related to income levels: in 2015, medical insurance subscribers with the highest income were twice more likely to have gout than those in the lowest income bracket. By contrast, the prevalence of gout in medical benefit recipients was 5.58- and 5.25-times higher than that of the general population and of those in the highest income bracket, respectively. Conclusion . The prevalence of gout has increased rapidly, although the degree of increase varied according to sex, age, region, and income group. This study sheds some light on the current prevalence of gout among national insurance subscribers in Korea, and will help educate patients and medical staff on the management of gout.

Supplementation of antihypertensive action of sodium nitroprusside (SNP) is almost standard practice and should obviate the need for potentially toxic doses to control blood pressure. Clonidine, an antihypertensive agent known to reduce sympathetic outfiow via alpha2-adrenergic receptor stimulation, has been shown to decrease MAC of halogenated agent, and to reduce the amount of SNP required to reduce the desired hypotension. To determine the effects of clonidine on the hemodynamics and intrapulmonary shunting during SNP infusion, clonidine and/or SNP were administered to 22 patients anesthetized with halothane-N2, O-O2 (FIO2:0.5) In one group of 11 patients, clonidine 1.5ug/kg was injected intravenously. In another group of 11 patients, clonidine 1.5 ug/kg was injected intravenously 30 minutes after starting the SNP infusion (3 ug/kg/min). The results were as follows. 1) Clonidine alone produced a small decrease in MAP (10%) and CI (8%) but other hemodynamic values remained unaltered. 2) Arterial oxygen tension and intrapulmonary shunting was not changed by clonidine. 3) Heart rate (15%) was increased , but MAP (29%), MPAP (24%), PCWP (25%), CVP (32% ), SVR (29%)and PVR(24%) were decreased significantly, and CI, SVI remained unchanged during SNP hypotension. 4) SNP caused a significant increase in intrapulmonary shunt fraction from 8.62% to 10.58% and a decrease in PaO2. 5) In group of clonidine under SNP infusion, conidine did not significantly affect the hemodynamic response to SNP except for 15% decrease in BP. 6) Clonidine caused no significant change on gas exchange effect of SNP. These results indicate that clonidine did not significantly affect the hemodynamics and intrapul-monary shunting during SNP hypotension. Therefore, clonidine could be used as a valuable adjuvant for reducing the amount of SNP and decreasing MAC of halothane.
Anesthesia* ; Blood Pressure ; Clonidine* ; Halothane ; Heart Rate ; Hemodynamics* ; Humans ; Hypotension* ; Nitroprusside* ; Oxygen ; Sodium*

The velopharyngeal dysfunction usually occurs in patients with previous operation of the cleft palate or with submucosal cleft palate. In case of velopharyngeal dysfunction without cleft palate, no study has been made when it comes to operative method and postoperative results. Here, we would like to present the operative methods and the postoperative results with the cases we've experienced. This study is based on seven cases of velopharyngeal dysfunction without cleft palate from 1999 to 2004. Analysis of age, sex, etiology, operative methods, satisfaction rate and speech evaluation was done. The patients were 3 males and 4 females, with an age ranged from 10 to 28 at the time of surgery. The follow-up period was more than six months. One case had bifid uvula, another had atypical anomaly in palate, and five cases had no anatomical abnormality. The palatal lengthening was done on one patient, the levator muscle repositioning on another patient and to the rest of them, the superiorly based posterior pharyngeal flap was done. It was difficult to determine the etiology of the velopharyngeal dysfunction without cleft palate. The speech improvement and the satisfaction rate of the patients and parents were diverse. Although the authors had a problem with statistical analysis between the operative age and the speech improvement, it was reasonable to perform a surgical operation because post operative speech improvement was observed in most cases regardless of age. There is little statistical correlation, but significantly higher outcomes were observed in palatal lengthening and levator muscle repositioning than in pharyngeal flap.
Cleft Palate* ; Female ; Follow-Up Studies ; Humans ; Male ; Palate ; Parents ; Speech Articulation Tests ; Uvula ; Velopharyngeal Insufficiency