Fabella impingement syndrome after total knee arthroplasty (TKA) is a rare condition. However, the location of the inserted prosthesis and the size of the fabella are considered major causative factors. Thus far, a conventional surgical excision of the impinged fabella is recommended treatment for the impingement. A 72-year-old woman was diagnosed with degenerative arthritis of the knee. She complained of fabella impingement due to an incompletely excised bony spur behind the posterolateral femoral prosthesis after TKA. The fabella and remaining bony spur were removed using an arthroscopic procedure. The impingement has not recurred and the range of motion (ROM) of the knee was improved after a 12 months follow-up. Arthroscopic surgery might be an alternative treatment for fabella impingement after TKA.
Aged ; Arthroplasty* ; Arthroscopy ; Female ; Follow-Up Studies ; Humans ; Knee* ; Osteoarthritis ; Prostheses and Implants ; Range of Motion, Articular

No abstract available.
Intussusception* ; Peutz-Jeghers Syndrome*

PURPOSE: The primary goal of this study was to evaluate the MR findings of systemic lupus erythematosus (SLE) patients with neuropsychiatric symptoms. MATERIALS AND METHODS: The MR images of 38 patients with SLE were evaluated based on the presence of the following abnormal lesions: the locations of the abnormal signal intensity lesions in the white matter, infarctions, a small vessel vasculopathy, leukoencephalopathy, hemorrhage, abscess, and other lesions. RESULTS: The MR images showed an abnormality in 22 of 38 (58%) episodes. Abnormal signal intensities were noted in the subcortical and periventricular white matter in six cases, acute territorial infarctions in five cases, multiple small acute embolic infarctions in four cases and a brain abscess in two cases. A reversible posterior leukoencephalopathy was found in one case. In addition, another patient had vasogenic edema with focal central cytotoxic edema at the pons. The entire cerebral and corpus callosum volumes were significantly smaller in four patients with SLE as compared to the volumes in healthy control subjects. CONCLUSION: SLE may induce variable MR imaging findings of the CNS. Recognition of the variable findings is helpful for easy diagnosis and prompt treatment.
Abscess ; Brain ; Brain Abscess ; Brain Diseases ; Central Nervous System ; Corpus Callosum ; Edema ; European Continental Ancestry Group ; Glycosaminoglycans ; Hemorrhage ; Humans ; Infarction ; Leukoencephalopathies ; Lupus Erythematosus, Systemic ; Lupus Vasculitis, Central Nervous System ; Pons

Lofgren's syndrome is an acute form of sarcoidosis characterized by erythema nodosum, bilateral hilar lymphadenopathy (BHL), and polyarthralgia or polyarthritis. This syndrome is common among Caucasians but rare in the Korean population. A 44-year-old woman was admitted to our hospital complaining of polyarthralgia. A chest radiograph revealed BHL and nodular shadows. Angiotensin-converting enzyme levels were within the normal range. Tissue biopsy from a mediastinum lymph node showed noncaseating granulomas. We diagnosed her with Lofgren's syndrome, an acute form of sarcoidosis.
Arthralgia ; Arthritis ; Biopsy ; Erythema Nodosum ; Female ; Granuloma ; Humans ; Lymph Nodes ; Lymphatic Diseases ; Mediastinum ; Reference Values ; Sarcoidosis ; Thorax

BACKGROUND AND OBJECTIVES: Epidemiologic and clinical trials have suggested that ozone exposure increase airway hyperresponsiveness and inflammatory response to allergen challenge in allergic asthmatics. But the effect of ozone exposure on the allergic rhinitis is still unclear. The purpose of this study was to determine whether ozone increases the nasal inflammatory response to allergen challenge in experimentally induced allergic rhinitis. MATERIALS AND METHODS: Forty Sprague- Dawley rats were divided into four groups : (A) NSS (normal saline) group, (B) group challenged by allergen (ovalbumin), (C) group exposed to ozone, and (D) group exposed to ozone followed by allergen (ovalbumin) challenge. To induce the allergic rhinitis in group B and D, rats was immunized intraperitoneally with ovalbumin, followed by intranasal nebulization of ovalbumin. In group C and D, rats were exposed to 0.3 ppm ozone for 3 days (6 hr/day). We recorded the symptoms (snort and scratching) for 5 min after the last nebulization. We also examined the infiltration of inflammatory cells, morphological changes of nasal mucosa, and Evans blue extravasation in septal rnucosa. RESULTS: Infiltration of neutrophils in nasal mucosa was significantly increased in group D compared with group B (p <0.05). Morphological changes such as loss of cilia and epithelial hyperplasia were more pronounced in group D than in group B (p <0.05). Evans blue extravasation was significantly higher in group D than in group B (p<0.05). CONCLUSION: These results may suggest that ozone enhances the inflammatory responses to allergens in allergic rhinitis patients.
Allergens ; Animals ; Cilia ; Evans Blue ; Humans ; Hyperplasia ; Nasal Mucosa ; Neutrophils ; Ovalbumin ; Ozone* ; Permeability ; Rats* ; Rhinitis*

No abstract available.
Adenoids* ; Carcinoma, Adenoid Cystic* ; Head* ; Neck*

Pigmented villonodular synovitis (PVNS) is a rare proliferative disease involving the synovial membranes. Complete excision with a total synovectomy is important for diffuse type PVNS because of its high recurrence rate. In the ankle, complete excision of diffuse type PVNS is difficult due to the anatomical structure of the ankle joint. This paper reports the author's experience of surgical treatment with combined open and arthroscopic synovectomy. In this manner, it is expected that the complications of the open procedure and the recurrence rate of arthroscopic procedure can be reduced.
Ankle Joint ; Ankle ; Recurrence ; Synovial Membrane ; Synovitis, Pigmented Villonodular

STUDY DESIGN: Prospective study. OBJECTIVES: This study compared the early postoperative analgesic effects and the postoperative nausea and vomiting (PONV) associated with 3 methods of pain control after posterior spinal decompression. SUMMARY OF LITERATURE REVIEW: Spinal surgery causes severe postoperative pain. Efficient and safe methods for postoperative analgesia after spinal surgery are necessary. MATERIALS AND METHODS: To determine the clinical symptoms and to assess improvements in postoperative pain, 52 patients in whom single-level posterior lumbar decompression was planned were randomly assigned to 3 groups. For postoperative pain control, 18 patients received a preoperative single-shot epidural injection (SEI), 16 patients received a postoperative continuous epidural injection (CEI), and 18 patients received only postoperative intravenous patient-controlled analgesia (IV-PCA). Patient ratings of pain intensity (visual analog scale score from 0 [no pain] to 10 [most severe pain]), nausea (from 0 [no nausea] to 5 [severe nausea]), and vomiting (from 0 [no vomiting] to 5 [severe vomiting]) were recorded immediately after the operation and at 4 hours, 12 hours, 1 day, and 2 days postoperatively. RESULTS: The CEI group showed significantly enhanced analgesic effects, followed by the SEI group and the IV PCA group (p < 0.05). PONV due to postoperative pain control was more severe in the IV PCA group than in the other 2 groups (p < 0.05). CONCLUSIONS: Continuous epidural injection (CEI) is effective for postoperative pain control and minimizes the occurrence of PONV after posterior spinal decompression.
Analgesia ; Analgesia, Patient-Controlled ; Decompression ; Humans ; Injections, Epidural ; Methods ; Nausea ; Pain, Postoperative ; Passive Cutaneous Anaphylaxis ; Postoperative Nausea and Vomiting ; Prospective Studies ; Spinal Stenosis ; Vomiting

OBJECTIVES: This study compared the early postoperative analgesic effects and the postoperative nausea and vomiting (PONV) associated with 3 methods of pain control after posterior spinal decompression.SUMMARY OF LITERATURE REVIEW: Spinal surgery causes severe postoperative pain. Efficient and safe methods for postoperative analgesia after spinal surgery are necessary. MATERIALS AND METHODS: To determine the clinical symptoms and to assess improvements in postoperative pain, 52 patients in whom single-level posterior lumbar decompression was planned were randomly assigned to 3 groups. For postoperative pain control, 18 patients received a preoperative single-shot epidural injection (SEI), 16 patients received a postoperative continuous epidural injection (CEI), and 18 patients received only postoperative intravenous patient-controlled analgesia (IV-PCA). Patient ratings of pain intensity (visual analog scale score from 0 [no pain] to 10 [most severe pain]), nausea (from 0 [no nausea] to 5 [severe nausea]), and vomiting (from 0 [no vomiting] to 5 [severe vomiting]) were recorded immediately after the operation and at 4 hours, 12 hours, 1 day, and 2 days postoperatively. RESULTS: The CEI group showed significantly enhanced analgesic effects, followed by the SEI group and the IV PCA group (p < 0.05). PONV due to postoperative pain control was more severe in the IV PCA group than in the other 2 groups (p < 0.05). CONCLUSIONS Continuous epidural injection (CEI) is effective for postoperative pain control and minimizes the occurrence of PONV after posterior spinal decompression.

PURPOSE: To evaluate the morbidity and mortality of children with status epilepticus(SE) as an initial seizure and to compare these according to age groups. METHODS: The 78 cases(38 cases <2 years and 38 cases > or = 2 years) with SE as an initial seizure admitted to the Chonnam national university hospital from Jan. 2000 to Jan. 2004 were reviewed. Developmental profiles, laboratory findings, etiologies and seizure types of SE and outcomes were compared in between two age groups, under and over 2 years. RESULTS: SE occurred predominantly in less than 5 years old. Febrile causes were the most common, which is significantly more in those under 2 years than over 2 years(P<0.05). whereas idiopathic and acute symptomatic causes were more common in those over 2 years(P<0.05). Generalized tonic-clonic seizures was the most common type. The mortality rate was 6.4 percent(5 cases:1 case <2 years and 4 cases > or = 2 years). The estimated occurrence of epilepsy after SE was 24.4 percent(19 cases:8 cases <2 years and 11 cases > or = 2 years). The neurologic sequelae after SE in cases that had developed normally before SE(62 cases:32 cases <2 years and 30 cases > or = 2 years) were observed in 20 cases(32.3 percent), and were more frequent over 2 years(21.9 percent vs. 43.3 percent, P<0.05). CONCLUSION: In this study death was less common and the neurologic sequelaes of SE as an initial seizure were less severe in children under 2 years of age. The reason seemed to be the difference in the etiology of SE with age.
Child* ; Child, Preschool ; Epilepsy ; Humans ; Jeollanam-do ; Mortality ; Seizures* ; Status Epilepticus*