Patellofemoral complications are the most frequent problems in total knee arthroplasty. In the literature, the subject of patella resurfacing and nonresurfacing is controversial. Twenty-seven osteoarthritic patients who received bilateral total knee prostheses were studied to evaluate the advantages and disadvantages of patella resurfacing prospectively. Only patients with mild patellofemoral disease were included in the study. The Ortholoc modular implant was used in all cases. Cementless femoral and tibial component were used. But, if we resurfaced the patella, cement was used. In all patients, patella resurfacing had been done in the left knee but not in the right knee. For the clinical analysis, We used Knee Rating Score of the Hospital for Special Surgery(HSS), For the roentgenographic analysis, We used Laurin's lateral patellofemoral angle & Merchant's congruence angle. In the follow up, blind test for patellar pain was performed to compare between right and left knee joint clinically. The average age was 61 years(range 28-72 years) and the average follow up was 21 months(range 12-27 months). Preoperative ROM was 104.4 degrees in right side and 106.7 degrees in left side. Postoperative ROM was 112.7 degrees in right side and 109.6 degrees in left side. Preoperative HSS Knee Rating Score was 53.1 point in right side and 54.8 point in left side. Postoperative HSS Knee Rating Score was 81.5 point in right side and 81.2 point in left side. In the plain knee AP view, preoperative tibiofemoral angle was varus 7.0 degrees in right side and varus 5.6 degrees in left side. Postoperative tibiofemoral angle was valgus 5.1 degrees in right side and valgus 4.9 degrees in left side. Preoperative Merchant's congruence angle was 14.9 degrees in right side and 15.3 degrees in left side. Postoperative Merchant's congruence angle was
Arthroplasty, Replacement, Knee ; Follow-Up Studies ; Humans ; Knee ; Knee Joint ; Knee Prosthesis ; Patella ; Prospective Studies ; Range of Motion, Articular

No abstract available.
Antibodies* ; Coxiella burnetii* ; Coxiella* ; Korea* ; Prevalence*

PURPOSE: To evaluate the radiologic manifestations of the rectal leiomyosarcoma. MATERIALS AND METHODS: We reviewed CT and barium study of 2 cases of rectal leiomyosarcoma, which were operated and pathologically proved. RESULTS: In both cases colon studies showed a huge smooth marginated filling defect in the rectum. Precontrast CT scans showed a well-circumscribed, slightly Iobulated, inhomogeneous mass without calcification. Postcontrast scans showed minimal enhancement with internal low-density areas. In pathologic specimens there were large areas of necrosis and hemorrhage in the masses. Pericolic fat infiltration, lymph node metastasis, or distant metastasis were not detected. CONCLUSION: Leiomyosarcoma is rarely developed in the rectum, but general radiologic findings are similar to that of other part of the gastrointestinal tracts except for the tendency of intraluminal growth due to narrow pelvic space.
Barium ; Colon ; Gastrointestinal Tract ; Hemorrhage ; Leiomyosarcoma* ; Lymph Nodes ; Necrosis ; Neoplasm Metastasis ; Rectum ; Tomography, X-Ray Computed

Radilogy plays an important role in evaluating patients with suspected adrenal gland pathology. Morphologicdelineation of adrenal gland is especially valuable in patients with clinical and/or biochemical evidence of adisturbance in adrenal function. Many diagnostic radiologic methods are avilable for demonstrating adrenallesions. CT overcomes many of the disadvantages of these other radiologic techniques. The high degree of spatialand density resolution allows precise demonstration of the normal adrenal glands as well as detection of bothsmall and large tumors in almost all patients. So CT of adrenal gland is an excellet nonivasive screening methodand definitive imaging technique. The authers have investigated the capability of CT to image the nomral size,location and shape of both glands. Knowledge of the range of normal is useful for optimal interpretation of CTscans in patients with suspected aderenal pathology. We reviewed CT scan of 150 cases without evidence of adrenaldisease. The following results were obtained: 1. There were 90 male and 60 female patients. 2. Their ages rangedfrom 20 to 60 years. 3. On CT, both gland were shown in 135 (90.0%), the right in 143(95.3%), the left in142(94.6%). 4. In the shape of adrenal glands, most of right adrenal gland was linear or comet shaped; 68(47.6%),most of left adrenal gland was inverted-Y shaped: 103(72.6%). 5. In the length of adrenal glands, theright was2.5+-0.77cm, the left was 2.9+-0.75cm. 6. In the width of adrenal glands, the right was 3.2+-0.74cm, the left was2.7+-0.57cm. 7. In the thickness of adrenal glands, the right was 0.5+-0.14cm, the left was 0.6+-0.16cm.
Adrenal Glands ; Female ; Humans ; Male ; Mass Screening ; Pathology ; Pheniramine ; Tomography, X-Ray Computed

The types of patellar component of total knee replacement prostheses are dome-shape, metalbacked, anatomically shaped, and press fit condylar type, etc. The fixation of inset patella type is achieved with bone cement supplemented by a central peg and a small extended flange around the circumference, providing resistance to torsional and shear loads. From October 1990 to June 1992, 53 cases in 40 patients had total knee arthroplasties. Ortholoc II implant was used in all patients. Cementless femoral and tibial component were used. But, cement was used in patellar component. The average follow up was 29 months(range 21-40 months). There were 37 women and 3 men and the average age was 51 years(range 22-71 years). The diagnosis of 40 patients was osteoarthritis in 25, rheumatoid arthritis in 9, infection sequelae in 6. For alignment of the patellar and congruency of the patellofemoral joint, additional retinacular release was done in 7 cases. The average preoperative Hospital for Special Surgery(H.S.S) knee rating score was 50.7 point, which improved to 89.4 point at last follow up. Postoperative patellar pain was 4 cases. In the roentgenorgraphic follow up, ratellar subluxation was 2 cases and lateral tilting of the patella was 5.9 degrees in 10 cases. The average patellar depth was 20.8mm preoperatively and 21.6mm postoperatively. In the Merchant's view, the preoperative lateral patellofemoral angle of Laurine was average 14.3 degree, which changed to average 16.4 degree at last follow up, and the preoperative Merchant's congruence angle was average 14 degrees, which decreased to average
Arthritis, Rheumatoid ; Arthroplasty ; Arthroplasty, Replacement, Knee ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Knee ; Male ; Osteoarthritis ; Patella ; Patellofemoral Joint ; Prostheses and Implants

Hirsutoid papillomas of vulvae present as smooth or filiform papules located on the inner surfaces of the labia minora. This disease is usually considered as anatomical variants of the vestibular mucosa. Differentiation from condyloma acuminata is important to avoid unnecessary treatment. Herein we report a case of hirsutoid papillomas of vulvae in a 21-year-old female who complained of pruritic papules on the vulva of one year's duration. Papules were located on the inner surfaces of the left labia minora and vestible of the vulva. Clinically, they were quite similar to condyloma acuminata. Histologically, however, the epithelium was devoid of features of human papillomavirus(HPV) infections such as koilocytosis, double nucleation, and dyskeratosis.
Epithelium ; Female ; Humans ; Mucous Membrane ; Papilloma* ; Vulva* ; Young Adult

BACKGROUND: Onychomycosis has become one of the common fungal infection. However, highly reliable and sensitive methods of detecting and identifying causative fungi of onychomycosis are not established yet. Polymerase chain reaction (PCR) analysis of clinical specimens including blood, sputum, urine, and cerebrospinal fluid collected from patient systemically infected fungus is known as a sensitive diagnostic method. But it has been questionable whether PCR analysis is also applicable to onychomycosis. OBJECTIVE: The purpose of this study was to develop a DNA-based diagnostic method to improve the sensitivity and specificity of detection and identification of pathogenic fungi of onychomycosis. METHODS: To detect the fungi in the nail, PCR was performed by using 4 sets of primer (TR1 & TR2, NS5 & NS6, B2F & B4R and CA1 & CA2) designed in conserved sequences of the small ribosomal subunit (185-rRNA) genes and restriction enzyme analysis of amplified product by Hae III was done to identify species. Nail specimens were obtained from 19 cases of onychomycosis confirm by fungus culture. RESULTS: 1. Preparation of nail powder, which is necessary for removal of keratin, and composition of lysis buffer with guanidinium thiocyanate, Tris-HCl, and beta -mercaptoethanol are the most proper modalities for isolation of fungal DNA from fungus-infesting nails. 2. Specific fragments of the 18S-rRNA gene of fungi, 581 bp, 308 bp, 688 bp and 1106 bp were amplified respectively. From sequences of 18S-rRNA gene of fungi by universal primers, dermatophytes (Trichophyton rubrum, Trichophyton mentagrophytes) and yeast (Candida albicans) yielded identical products. 3. Using Hae III endonuclease, digested patterns of fragment of Trichophyton rubrum and Candida albicans resulted in different pattern. CONCLUSION: This method released enough DNA from fungus-infected nails to result in proper amplification and it can be possible to differentiate dermatophytes, yeasts, and molds using Hae III endonuclease. The present study is the first one to demonstrate the feasibility of this molecular biologic approach to identify fungi in the infected nail. Therefore, precise detection and identification of the causative fungi would be of help in investigating distribution of the causative fungi of onychomycosis as well as appropriate treatment of the disease.
Arthrodermataceae ; Candida albicans ; Cerebrospinal Fluid ; Conserved Sequence ; Diagnosis* ; DNA ; DNA, Fungal ; Fungi* ; Guanidine ; Humans ; Onychomycosis* ; Polymerase Chain Reaction* ; Restriction Mapping* ; Ribosome Subunits, Small ; Sensitivity and Specificity ; Sputum ; Trichophyton ; Yeasts

PURPOSE: To evaluate the diagnostic capabilities of the low-field (0.2T) magnetic resonance (MR) system in the detection of the superior labrum anterior to posterior (SLAP) lesion. MATERIALS AND METHODS: One hundred fifty patients underwent magnetic resonance imaging of the shoulder over a 7-month period. Forty-six patients underwent arthroscopic surgery, and the surgical results were correlated with the findings of the MR imaging. Arthroscopic procedures were performed within a mean of 8 days after MR imaging. MR imaging of the shoulder was conducted as follows: shoulder coil; T1-weighted spin echo, coronal-oblique images; T2-weighted gradient echo, coronal-oblique and axial images; and T2-weighted spin echo, coronal-oblique and sagittal-oblique images. Prospectively, one radiologist interpreted the MR images. RESULTS: The results of surgery were as follows: SLAP II in 26 shoulders, SLAP III in 1 shoulder, SLAP IV in 1 shoulder, normal labrum in 6 shoulders. For SLAP lesions with a higher grade than type 2, the sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of the low-field MRI were 85.7%, 55.5%, 75%, 71%, and 74%, respectively. CONCLUSION: There was relatively good agreement for the comparison of the MR results obtained using a low-field MR system with the surgical findings for identifying SLAP lesions.
Arthroscopy ; Humans ; Magnetic Resonance Imaging ; Prospective Studies ; Sensitivity and Specificity ; Shoulder

Tuberculosis of the thyroid gland is extremely rare, with only a few reported cases in the recent literature. The diagnosis is based entirely upon the histological picture of the tubercle, which consists of aggregates of mononuclear epithelial cells, giants cells, and a border of lymphocytes. Tuberculosis may involve the thyroid gland in two main forms. One common form spreads to the thyroid as part of generalized dissemination, and the other one is focal or caseous tuberculosis of the thyroid, presenting as a nodule, thyroiditis, an abscess, or a carcinoma-like mass. The differential diagnosis from malignancy and other non tuberculous granulomatous lesion is impossible upon the clinical ground. Surgical intervention is essential in order to establish the definitive diagnosis and to exclude the possibility of tumors. We experienced a case of the tuberculosis of the thyroid gland presenting with palpable thyroid nodule in a 44 year-old female patient. She was clinically and biochemically euthyroid and her CT scans demonstrated multiple low density in both thyroid gland with strands in the subcutaneous fat layer. The mass was removed surgically and confirmed to be tuberculosis.
Abscess ; Adult ; Diagnosis ; Diagnosis, Differential ; Epithelial Cells ; Female ; Humans ; Lymphocytes ; Subcutaneous Fat ; Thyroid Gland* ; Thyroid Nodule ; Tomography, X-Ray Computed ; Tuberculosis*

Purpose: Alport syndrome (AS) is one of the most common inherited renal diseases caused due to mutations of genes encoding specific proteins of the type IV collagen family, and its major clinical manifestations include progressive renal failure, sensorineural deafness, and ocular abnormalities. We investigated the clinical characteristics and long-term prognosis of AS in Korean pediatric and adult populations. Methods: We conducted a retrospective review of medical records of 33 children and adults who had been diagnosed or treated with AS from 1985 to 2019. Results: The mean age of the 33 patients diagnosed with AS was 16.2±13.6 years, and the male-to-female ratio was 2:1. At the first visit, recurrent gross hematuria was the most common initial symptom. In 10 of 33 patients (30.3%), sensorineural hearing loss (SNHL) was diagnosed, but none had ophthalmic problems. Moreover, 11 of 33 patients (33.3%) had advanced to end-stage renal disease (ESRD), and a significant difference was observed in the age of the patients who progressed to ESRD based on the presence or absence of SNHL (P =0.035). Conclusion SNHL in AS can be an important prognostic factor for long-term deterioration of renal function. Further investigation is required to confirm the clinical course and the genetic characteristics of AS in Korea through prospective national cohort studies.