No abstract available.
Uterine Prolapse*

Alveolar soft-part sarcoma is a rare malignant neoplasm. It occurs most commonly in the deep tissue of the extremity, particularly in the anterior aspect of the thigh. It usually presents as a slow-growing, painless mass with little functional impairment. Because of the relative lack of symptoms, it may be easily overlooked. The course of the disease tends to be long but unrelenting, and local recurrences are frequent. There were no lifetime cures in the reported cases. This tumor is relatively unknown to orthopaedic surgeons, and a wider knowledge of its characteristics may lead to its more frequent recognization, Recently, two cases of alveolar soft-part sarcoma were encountered on the orthopaedic department of Dong-kang Hospital, Ulsan. In case 1, the tumor was found in the vastus lateralis muscle; and in case 2, vastus intermedius muscle. The authors will present these cases in detail to provide a glance at this very rare but more frequently recognizable tumor, the alveolar soft-part sarcorna.
Extremities ; Quadriceps Muscle ; Recurrence ; Sarcoma ; Sarcoma, Alveolar Soft Part ; Surgeons ; Thigh ; Ulsan

Neuro-Behçet's disease (NBD) represents a significant complication of Behçet's syndrome, potentially leading to elevated mortality and disability rates. The standard treatment for parenchymal NBD typically entails administering high-dose corticosteroids to prompt rapid-onset effects, coupled with immunosuppressants to prevent subsequent relapses. A 48-year-old male with NBD presented with progressively worsening dysarthria over 9 months. This patient experienced increased intraocular pressure while using glucocorticoids, which worsened his pre-existing glaucoma. The patient had a prior diagnosis of NBD and presented with progressive dysarthria over a period of nine months, leading to a brain magnetic resonance imaging (MRI) scan. The brain MRI revealed multifocal punctate high signal intensities in the left frontoparietal area, insula, and basal ganglia. Instead of the standard steroid pulse therapy, the patient received adalimumab-cyclophosphamide combination as an alternative induction therapy. Subsequent serial brain MRI scans exhibited no emergence of new lesions, and the patient remained devoid of clinical relapses even after 17 months from the commencement of induction treatment. Adalimumab-cyclophosphamide combination could be used as a corticosteroid-free induction strategy for NBD. Further investigations are warranted to establish the most suitable combination regimen.

The purpose of this study is to validate the potential etiologic factors for temporomandibular disorder(TMD). TMJ arthroscopic examination was performed in upper joint compartment of 32 joints from 20 patients with mandibular fractures. Synovial fluid was collected from the upper joint space during pumping manipulation with normal saline. Cytologic smearing and histomorphologic exam of synovial fluid were performed in 15 joints. Prostaglandin E2(PGE2) concentration was measured in 11 joints. Leukotriene B4(LTB4) concentration was measured in 8 joints. There were several arthroscopic variables such as ecchymosis, fibrillation, and adhesion. Histomorphologic exam showed a variety of findings such as bloody smears, cellular cluster, degenerated cells and cartilage, undifferentiated crystal. Mean PGE2 concentrations were 316.5 pg/ml. Mean LTB4 concentrations were 45.9pg/ml. This study demonstrated a variety of findings on inflammatory and degenerative changes of TMJ. Because acute trauma such as mandibular fracture is a major etiologic factor in cartilage degradation and biochemical and intraarticular pathology, clinicians must identify and address TMJ signs and symptoms during follow-up periods in the long term.
Arthroscopy ; Cartilage ; Dinoprostone ; Ecchymosis ; Follow-Up Studies ; Humans ; Joints* ; Leukotriene B4 ; Mandibular Fractures* ; Pathology ; Synovial Fluid ; Temporomandibular Joint*

No abstract available.

Seizure is a foreseeable risk in patients with brain lesion. However, seizure during treating non-brain lesion is not a familiar situation to neurosurgeon. Posterior reversible encephalopathy syndrome (PRES) is a relatively common situation after systemic chemotherapy. The aim of this study is to make neurosurgeons aware of this potential medical problem. A 52-year-old woman with advanced gastric cancer, presented with low back pain due to spinal metastasis at the 4th lumbar vertebra. Ten cycles of chemotherapy with FOLFOX (5-Fluoruracil/Oxaliplatin) had been completed 23 days ago. Two days before the planned operation, a generalized tonic clonic seizure occurred. She did not have a history of hypertension or seizure. The seizure was stopped with lorazepam 4mg. The brain magnetic resonance (MR) imaging showed high signal changes in both parieto-occipital lobes on the T2-weighted images, and these were partially enhanced, suggesting PRES. The surgery was preceded by treatment with an antiepileptic drug. The MR images, taken 1.5 months after the seizure, showed that the lesion was no longer present. At 3 month follow-up, no additional seizure attack occurred without any seizure medication. The possibility of a seizure attack should be considered if the patient has a history of chemotherapy.
Brain ; Female ; Follow-Up Studies ; Humans ; Hypertension ; Lorazepam ; Low Back Pain ; Magnetic Resonance Spectroscopy ; Middle Aged ; Neoplasm Metastasis ; Organoplatinum Compounds ; Seizures ; Spine ; Stomach Neoplasms

PURPOSE: We aimed to evaluate the outcome of fixation with cannulated screws for valgus impacted femoral neck fractures in patients over 70 years of age. MATERIALS AND METHODS: We reviewed the outcome in 33 patients older than 70 years with valgus impacted femoral neck fractures who were treated with cannulated screws fixation from May 2007 to December 2010. These patients were followed for at least a year. We assessed the fixation failure rate, body mass index (BMI), bone mineral density (BMD) of proximal femur, distance between screw tip and joint, number of screws and time from fracture to operation. RESULTS: We identified six patients (18.2%) with failure. Two patients with subtrochanteric fractures through the screw insertion site and another patient with osteonecrosis were excluded from the fixation failure group. No difference was found in age, BMI, BMD of proximal femur, distance between screw tip and joint, number of screws and time from fracture to operation between failure and non-failure groups. CONCLUSION: The failure rate of cannualted screw fixation for valgus impacted femoral neck fractures in the elderly patients was not low. Risk of failure should be considered in the management of these patients and accurate assessment for fracture type should be performed using computed tomogram and clinical evaluation.
Aged ; Body Mass Index ; Bone Density ; Femoral Neck Fractures* ; Femur ; Hip Fractures ; Humans ; Joints ; Osteonecrosis

PURPOSE: To report a case of a young male patient with retinitis pigmentosa (RP) accompanied by vitritis and neovascularization of the optic disk in both eyes who underwent unilateral vitrectomy for the treatment of vitreous hemorrhage in the right eye. CASE SUMMARY: An 8-year-old boy visited our clinic with a complaint of night blindness. Both eyes showed inflammatory cells in the anterior vitreous and neovascularization of the optic disk confirmed by fluorescein angiography. Extensive vitreous hemorrhage developed in his right eye and he underwent unilateral vitrectomy. His final visual acuity was 0.6 in both eyes. CONCLUSIONS: Vitreous hemorrhage may be related to chronic inflammation in the vitreous and is a very rare RP complication. Vitrectomy can be an effective treatment option for RP complicated by vitreous hemorrhage.
Eye ; Fluorescein Angiography ; Humans ; Inflammation ; Male ; Night Blindness ; Optic Disk ; Retinitis ; Retinitis Pigmentosa ; Visual Acuity ; Vitrectomy ; Vitreous Hemorrhage

Bilateral ectopic testes, located in the perineum is a rare disease with no cases reported yet in Korea. We report a case of bilateral perineal ectopic testes in a 7-month-old infant who visited for evaluation of both non palpable testis in scrotum. External genitalia was male in appearance and cystic masses were palpated in both inguinal area. Serum testosterone level was lower than 0.01 ng/mL and suspicious hernial sac-like structures were seen in both inguinal area on pelvic ultrasonography. After 4 weeks of total 12,000IU hCG(human chorionic gonadotropin) therapy in pediatrics, serial follow up was done for 2 months and bilateral palpable masses were identified on deep perineal area, so bilateral orchiopexy was carried out.
Chorion ; Follow-Up Studies ; Genitalia ; Humans ; Infant ; Korea ; Male ; Orchiopexy* ; Pediatrics ; Perineum ; Rare Diseases ; Scrotum ; Testis* ; Testosterone ; Ultrasonography

Pancreatic candidiasis can develop in patients with acute pancreatitis, compromised immune responses, or iatrogenic intervention. This paper reports a case of pancreatic candidiasis presenting as a solid pancreatic mass in a patient without the risk factors. A previously healthy 37-year-old man visited the emergency department with left flank pain. Abdominal CT revealed a 5 cm, irregular heterogeneous enhancing mass accompanied by a left adrenal mass. Positron emission tomography-computed tomography and endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) could not discriminate pancreatic cancer from infectious disease. A laparoscopic exploration was performed for an accurate diagnosis. After distal pancreatectomy with splenectomy and left adrenalectomy, pancreatic candidiasis and adrenal cortical adenoma were diagnosed based on the pathology findings. His condition improved after the treatment with fluconazole. This paper reports a case of primary pancreatic candidiasis mimicking pancreatic cancer in an immunocompetent patient with a review of the relevant literature.