In 1941, Jaffe and coworkers studied a lesion with histologic appearance of fibrous stroma, pigmented deposition and histiocytic infiltration as well as giant cell, for which they named pigmented villonodular synovitis, bursitis and tenosynovitis. Thereafter many authors have discussed etiology, clinical and radiological features, pathology and treatment regarding the disease. Almost all, this disease is monoarticular and knee joint is most common site. We experienced a case of localized pigmented villonodular synovitis involving an shoulder joint which was treated by local excision and obtained good result.
Bursitis ; Giant Cells ; Knee Joint ; Pathology ; Shoulder Joint ; Shoulder ; Synovitis, Pigmented Villonodular ; Tenosynovitis

A 43-year-old woman presented with numerous cutaneous neurofibromas, limited to the left anterior chest(T2-3) and the right lower back(L1-2). These had been present for 10 years. Neither cafe-au-lait spot, intertriginous freckle, nor Lisch nodule was found. The family history was negative for neurofibromatosis. Biopsy specimens showed circumscribed, nonencapsulated neurofibromas. The present case was a rare form of bilateral segmental neurofibromatosis in that while most of the reported cases involved the same dermatome bilaterally, she had bilaterally different dermatomal neurofibromas.
Adult ; Biopsy ; Cafe-au-Lait Spots ; Female ; Humans ; Melanosis ; Neurofibroma ; Neurofibromatoses*

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

Surgical stabilization using instrumentation for thoracolumbar injuries offers several advantages such as nearly anatomic reduction of fractures, protection of neurologic structures and most importantly early ambulation of the patient. The treatment of fracture-dislocation of the thoracolumbar spine has been progressively improved over the past decades and recently a lot of new device have been introduced to improve fixability of the involved vertebrae three dimensionally and short segmental fixation as possible. The authors have treated 17 cases of unstable thoracolumbar fracture using Cotrel-Dubousset instrumentation in the Department of Orthopedic Surgery, Kangdong Sacred Heart Hospital from Jan. 1988 to Jan. 1989 with the following results: 1. Bursting fractures are the most common type(52.9%) of mechanism of injury. 2. Excellent anatomic reductions were obtained and compression, wedging and local kyphotic deformities were nicely corrected. 3. Short segmental fixation can preserve the maximal spinal mobility. 4. No significant loss of reduction or loosening of implant was found. 5. Remarkable neurologic recoveries were observed in cases of incomplete cord lesion. 6. Significant neurologic recovery was found in patients treated with laminectomy and Cotrel-Dubousset instrumentation.
Congenital Abnormalities ; Early Ambulation ; Heart ; Humans ; Laminectomy ; Orthopedics ; Spine

Fractures of the tibial condyles, involving as they do weight-bearing articular surfaces and frequently accompanied by soft tissue injuries such as collateral ligaments, cruciate ligaments, and menisci present a variety of problems in treatment and prognosis. Slee, Apley, and others maintained the opinion that most fractures of the tibial condyles could be managed conservatively. On the other hand, Rombold, Schatzker, and others seemed to consider closed treatment to be virtually s form of therapeutic nihilism and adviced open reduction. But recently most authors agree that the method of treatment has to be selected in each individual case, and recommand anatomical reduction of the fracture as possible and early knee motion. The authors have treated 17 cases of tibial condylar fractures with arthroscopic management and extraarticular distal approach in the Department of Orthopedic surpery, Kang Dong Sacred Heart Hospital from Oct. 1986 to Jul. 1989. Of the above cases, 11 cases could be followed for a period of anywhere from 1 year to 31/2 years and analysed according to the cause, classification, treatment, and result. The following results were obtained from the analysis of 11 tibial condylar fractures. l. Of the 11 cases, 7 (63.6%) were male and 4 (36.4%) were female. 2. Of the 11 cases, 7 (63.6%) were due to traffic accident (5 pedestrians, 2 occupants) and 3 (27.3%) were due to fall from height. 3. Among 11 cases, 7 (63.6%) were associated with other injuries. 4. Bone graft was needed in 5 cases. 5. All were treated by arthroscopic management with anatomically and functionally good results. 6. By arthroscopic mangement, it was easy to find and treat the accompanying intraarticular lesion. 7. With early active and C.P.M. exercise, almost full range of motion was obtained in all cases.
Accidents, Traffic ; Classification ; Collateral Ligaments ; Female ; Hand ; Heart ; Humans ; Knee ; Ligaments ; Male ; Methods ; Orthopedics ; Pedestrians ; Prognosis ; Range of Motion, Articular ; Soft Tissue Injuries ; Tibia ; Transplants ; Weight-Bearing

BACKGROUND: The purpose of this article was to identify the risk factors related to development of hemodynamically significant cardiac arrythmias in patients with mechanical ventilation. METHODS AND RESULTS: Holter recording and echocardiogram were performed after 30 minutes of ventilator initiation in patients on mechanical ventilation(MV) owing to respiratory failure(RF) from various reasons. From 68 patients, hemodynamically significant cardiac arrythmias were detected in 18 patients(26.5%). Initial mean arterial pressure, maximal heart rate, and initial pH were identified as risk factors for hemodynamically significant cardiac arrythmias. Additionally, the patients with pressure-controlled ventilation as an initial ventilatory mode developed hemodynamically significant cardiac arrythmias less frequently than the patients with other modes(15.8% vs. 40%, p=0.03). In multivariate analysis, initial mean arterial pressure(<70mmHg, odds ratio[OR]:5.5;95% confidence interval[CI]:1.2 to 24.2, p=0.026), maximal heart rate(>120/min, OR:19.7;95% CI:2.0 to 190.0, p=0.01), and pressure-controlled ventilation(OR:0.13,95% CI:0.03 to 0.55, p=0.006) were associated with the development of hemodynamically significant cardiac arrhythmias. CONCLUSION: Theses findings suggest that during the early stages of mechanical ventilation with acute respiratory failure, hemodynamically significant cardiac arrhythmias are directly associated with tachycardia(>120/min), initial MAP(<70mmHg), and, inversely, the initial use of pressure-controlled ventilation.
Arrhythmias, Cardiac* ; Arterial Pressure ; Heart ; Heart Rate ; Humans ; Hydrogen-Ion Concentration ; Multivariate Analysis ; Respiration, Artificial* ; Respiratory Insufficiency* ; Risk Factors* ; Ventilation ; Ventilators, Mechanical

We report a case of congenital vellus hamartoma, which consists of numerous matured vellus hair follicles and sebaceous glands. This patient is 4-month-old male with multiple, variable sized nodules on the right epicanthsl fold area since birth. Histopathologically, some of the infundibular portion of the vellus hair shows irregular and reticulated hyperplasia. There are numerous well-formed vellus hair follicles surrounded with thick fibrous sheath and some of them are associated with rudiment sebaceous glands.
Hair ; Hair Follicle ; Hamartoma* ; Humans ; Hyperplasia ; Infant ; Male ; Parturition ; Sebaceous Glands

Many physiologic studies have been carried out to identify the neurotransmitters involved in regulating the motility of the smooth muscle in the vas deferens, but the transmitter of a nonadrenergic and non-cholinergic inhibitory nerves has not been clearly identified. We investigated the role of nitric oxide in response to sympathetic motor activity in the rat vas deferens. 1. Nitroprusside and L-NAME had neither contractile nor relaxing effects directly. On the stabilized muscle strips of rat vas deferens, norepinephrine induced a phasic contraction for 10 seconds followed by the sustained tonic contraction. The phasic contraction of norepinephrine was increased by the pretreatment of nitroprusside(p>0.05) and decreased by LNAME(p<0.01). This tonic contraction was decreased dose-dependently by the pretreatment of nitroprusside(p<0.01), and increased by L-NAME(p<0.01). On the muscle strips of rat vas deferens, submaximally precontracted with norepinephrine, nitroprusside potentiated the contraction, followed by the delayed, sustained relaxation, which was blocked by L-NAME. 2. On the muscle strips of rat vas deferens, electrical field stimulation induced an initial phasic contraction for 2-3 seconds, followed by the tonic contraction, which was blocked by L-NAME dose-dependently. The phasic contraction of electrical field stimulation was increased by the pretreatment of nitroprusside(p>0.05) and decreased by L-NAME(p<0.01). This tonic contraction was decreased by the pretreatment of nitroprusside dose-dependently(p<0.01), and increased by L-NAME(.p<0.01). With these results, nitric oxide has the excitatory effect at the phasic contraction, and the inhibitory effect at the tonic contraction in response to sympathetic motor activity in the rat vas deferens partially.
Animals ; Motor Activity* ; Muscle, Smooth ; Neurotransmitter Agents ; NG-Nitroarginine Methyl Ester ; Nitric Oxide* ; Nitroprusside ; Norepinephrine ; Rats* ; Relaxation ; Vas Deferens*

Many physiologic studies have been carried out to identify the neurotransmitters involved in regulating the motility of the smooth muscle in the vas deferens, but the transmitter of a nonadrenergic and non-cholinergic inhibitory nerves has not been clearly identified. We investigated the role of nitric oxide in response to sympathetic motor activity in the rat vas deferens. 1. Nitroprusside and L-NAME had neither contractile nor relaxing effects directly. On the stabilized muscle strips of rat vas deferens, norepinephrine induced a phasic contraction for 10 seconds followed by the sustained tonic contraction. The phasic contraction of norepinephrine was increased by the pretreatment of nitroprusside(p>0.05) and decreased by LNAME(p<0.01). This tonic contraction was decreased dose-dependently by the pretreatment of nitroprusside(p<0.01), and increased by L-NAME(p<0.01). On the muscle strips of rat vas deferens, submaximally precontracted with norepinephrine, nitroprusside potentiated the contraction, followed by the delayed, sustained relaxation, which was blocked by L-NAME. 2. On the muscle strips of rat vas deferens, electrical field stimulation induced an initial phasic contraction for 2-3 seconds, followed by the tonic contraction, which was blocked by L-NAME dose-dependently. The phasic contraction of electrical field stimulation was increased by the pretreatment of nitroprusside(p>0.05) and decreased by L-NAME(p<0.01). This tonic contraction was decreased by the pretreatment of nitroprusside dose-dependently(p<0.01), and increased by L-NAME(.p<0.01). With these results, nitric oxide has the excitatory effect at the phasic contraction, and the inhibitory effect at the tonic contraction in response to sympathetic motor activity in the rat vas deferens partially.
Animals ; Motor Activity* ; Muscle, Smooth ; Neurotransmitter Agents ; NG-Nitroarginine Methyl Ester ; Nitric Oxide* ; Nitroprusside ; Norepinephrine ; Rats* ; Relaxation ; Vas Deferens*

PURPOSE: Carbon monoxide (CO) is produced during the degradation of hemoglobin to heme (iron protoporphyrin) and present in various tissues including brain. CO is believed to activate soluble guanylate cyclase to exert its action on the smooth muscles. the effects of CO and its relationships to adrenergic or cholinergic mechanisms were studied using the isolated rabbit corpus cavernosal strips, and the effects of CO and NO were further investigated. MATERIALS AND METHODS: Using adult New Zealand rabbits, the corpus cavernosal strip was carefully prepared from rabbit penis and suspended in an 10ml organ bath containing Tyrode solution. When a stable tension level of the strip had been attained, drugs were added to the organ bath the change of motility of the strip was recorded on a computerized polygraph. RESULTS: The NO donor, sodium nitroprusside (SNP) and CO caused a dosedependent relaxation of the cavernosal strip of the rabbit penis. Pretreatment of SNP and CO had no effect on contraction induced by adrenergic drugs and the effects of SNP and CO was not affected by atropine. The relaxation effects of SNP were inhibited by NO scavenger pyrogallol, inhibitor of soluble guanylate cyclase 1H-[1,2,4] oxadiazolo[4,3-a] quinoxalin-1-one (ODQ) and methylene blue. The relaxation effects of CO were significantly inhibited by ODQ and methylene blue. the relaxation effects by acetylcholine were inhibited by NO synthase inhibitor L-nitroarginine methyl ester (NAME) and deendothelialization, but not affected by zinc protoporphyrin (ZnPP), the heme oxidase inhibitor. On the immunostaining of heme oxidase (HO) in corpus cavernosal smooth muscle strip, the positive staining for HO was observed in the perivascular nerve fibers. CONCLUSIONS: The relaxation effect of NO was confirmed, and CO exerts an endothelium dependent relaxing effect on the cavernosal strip of the rabbit penis similar to NO. This action is seem to be mediated by soluble guanylate cyclase, and the actions of CO is also mediated by similar guanylate cyclase system.
Acetylcholine ; Adrenergic Agents ; Adult ; Atropine ; Baths ; Brain ; Carbon Monoxide* ; Carbon* ; Endothelium ; Guanylate Cyclase ; Heme ; Humans ; Male ; Methylene Blue ; Muscle, Smooth ; Nerve Fibers ; Nitric Oxide ; Nitric Oxide Synthase ; Nitroprusside ; Oxidoreductases ; Penis ; Pyrogallol ; Rabbits ; Relaxation ; Tissue Donors ; Zinc