The anterior horn of the medial meniscus is the site of most variations, but anomalies of the medial meniscus are extremely rare. From July 1990 through December 1994, the authors performed arthroscopy on 1068 symptomatic knee joints and incidentally found anomalous insertion of the anterior horn of the medial meniscus into the anterior cruciate ligament in eleven knees. They had another lesion(7 discoid lateral meniscus with or without tear, medial collateral ligament tear, Posterior cruciate ligament avulsion fracture). All but one discoid lateral menisci were reshaped, one had to be treated by total lateral meniscectomy, discoid medial meniscus also by reshaping, torn medial meniscus by partial meniscectomy, torn medial collateral ligament by repair and avulsion fracture of posterior cruciate ligament by arthroscopic pinmonths(average, 21.7 months) after surgery. The results were satisfactory except for 2 patients. One damaged his knee in a traffic accident and the other was treated by total meniscectomy of discoid lateral meniscus. It was concluded that this anomaly was not related to the patient's symptoms and mainly associated with discoid lateral meniscus.
Accidents, Traffic ; Animals ; Anterior Cruciate Ligament ; Arthroscopy ; Collateral Ligaments ; Horns ; Humans ; Knee ; Knee Joint ; Menisci, Tibial ; Posterior Cruciate Ligament ; Tears

Chest CT is the most useful modality in the diagnosis of primary lung cancer, particularly in patients with recurrent pneumonia which are resistant to antibiotic therapy and in high risk age groups for cancer, The purpose of this examination is to assess the usefulness of CT in pneumonia types of lung cancer. The authors retrospectively analyzed 15 histologically proven cases of pneumonic type lung cancer, which had no evidence of primary lung mass, mediastinal lymphadenopathy or other metastatic lesion on piain chest radiography. On CT scan, a primary lung mass was identified in 13 patients(87%, bronchial obstruction was identified in 12 patients(80%), and metastatic foci was found in the bone(one patient), liver(one patient), and spleen(one patients). In Conclusion, CT scan is a useful method to detect the mediastinal lymphadenopathy or pulmonary mass and also should be the initial radiolographic procedure for diagnosis of lung cancer in patients with recurrent pneumonia on simple chest radiography.
Diagnosis ; Humans ; Lung Neoplasms* ; Lung* ; Lymphatic Diseases ; Methods ; Pneumonia* ; Radiography ; Retrospective Studies ; Thorax ; Tomography, X-Ray Computed

Fiberoptic bronchoscopy is a valuable diagnostic and therapeutic procedure in many clinical situations and is relatively simple to perform with proper technique. Local anesthetic technique is often preferable to general anesthesia for bronchoscopies since these examinations are mostly undertaken as outpatient procedures. Inhaled topical lidocaine, used to produce anesthesia of the repiratory tract prior to bronchoscopy, may cause anaphylactoid reaction in patients. However lidocaine hypersensitivity reaction is uncommon. We report the case of death due to hypersensitivity to topical lidocaine spray given during routine premedication for this procedure. The possibility of bronchospasm secondary to an adverse reaction to premedication or anesthesia must also be considered.
Anaphylaxis* ; Anesthesia* ; Anesthesia, General ; Bronchial Spasm ; Bronchoscopy* ; Humans ; Hypersensitivity ; Lidocaine* ; Outpatients ; Premedication

The inverted nipple presents many problems including both cosmetic and functional aspects and impairment in breast feeding. the histopathologic characters of inverted nipple are that inverted nipple has less fibromuscular tissue than normal nipple and has short lactiferous duct and dense fibrous tissue. Many surgical and non-surgical techniques have been designed for correction of the inverted nipple. But most of these techniques have produced unsatisfactory problems. especially undesirable recurrence is most important problem. We experienced 19 inverted nipples in 12 patients between March 1995 and January 1998. We combined modified Teimourian method, purse-string suture and Z-plasty. and had good result for 3weeks to 30months follow up. This method was effective for correction of the inverted nipple with low recurrence rate and simple techniques.
Breast Feeding ; Follow-Up Studies ; Humans ; Nipples* ; Recurrence ; Sutures

Castleman's disease(Giant lymph node hyperplasia) is a pathologic entity of unknown etilogy, as attested to bythe number of names it has received, lymphoid hamartoma, angiomatous hamartoma, and giant lymph node, etc.Although the mediastinum is its most common location, it also occures in other areas of the body, usually wherelymph nodes are normally found. Authors have been experienced 2 cases of histologically porven Castleman's diseaseduring recent 3 years in Kyung Hee University Hospital, and present its radiological and pathological findings asmediastinal mass.
Hamartoma ; Lymph Nodes ; Mediastinum

BACKGROUND: Tufted angioma is an uncommon slowly progressive vascular tumor found typically in infants and young children with characteristic histologic findings, so called "cannonball" appearance. OBJECTIVE: The purpose of this study was aimed to investigate the clinical and histopathological characteristics of tufted angioma and the response to intralesional steroid. METHODS: Clinical information of 10 patients with tufted angioma diagnosed in Severance hospital and Pundang CHA hospital from 1983 to 1999 was obtained from the medical records and clinical follow-ups. We re-evaluated 10 biopsy specimens obtained from them with routine H&E staining. RESULTS: Five male and five female patients were included. In 9 patients the lesion appeared before 2 months of age. Four had a lesion at birth. The thigh was the most common site. The clinical symptoms were diverse, but characteristically tenderness was present in most cases. In all the patients the lesions had a tendency to spread progressively. Microscopically, numerous, distinct, variably sized, tightly packed capillary and endothelial cellular lobules were scattered in the dermis. There were characteristic semilunar spaces adjacent to the capillary tufts. Six patients received intralesional triamcinolone. This treatment was found to be effective in 5 patients who experienced remarkable improvement. The improved cases had similar histologic findings which were composed of cellular mass more than lumen formation. We classified our specimens into two categories, one with more cellular mass and the other with more lumen formation in relative proportion. The former was different from the latter in that it had more solid appearance and more definite margin. And we realized that it was useful to divide into these two categories since its response to treatment could be different. CONCLUSIONS: Tufted angioma is a relatively uncommon disease with characteristic histopathologic findings. It seems not to regress spontaneously. So early treatment is required to pre-vent further spreading up to the extent. We treated 6 patients with intralesional injection of triamcinolone and 5 patients experienced marked improvement which had more cellular mass more than lumen formation histopathologically.
Biopsy ; Capillaries ; Child ; Dermis ; Female ; Follow-Up Studies ; Hemangioma ; Humans ; Infant ; Injections, Intralesional ; Male ; Medical Records ; Parturition ; Thigh ; Triamcinolone

The wrist, or carpus, is a deformable anatomic entity composed of 8 small carpal bones (scaphoid, lunate, triquetrum, pisiform, hamate, capitate, trapezium and trapezoid) and the surrounding soft-tissue structures. We should get radiological knowledge of normal wrist in order to identify pathology of that. So we measured the several values on AP, PA and lateral roentgenograms of 228 normal wrist(male : 124 cases, femal: 104 cases). The following results were obtained: 1. Scapholunate gap : 1.4±0.5mm 2. Ulnar variance : 1.3 ±1.7mm, Positive variance … 59.7%, Neutral variance … 25.4% 3. Carpal height ratio : 0.543 ±0.078 4. Carpal ulner distance ratio : 0.32 ±0.04 5. Scapholunate angle : 45.8 ± 8.7° 6. Capitatolunate angle : 19.3 ± 8.2° 7. Radiolunate angle : 8.9 ± 4.7° 8. Ulnar tilt: 23.5 ± 3.3° 9. Volar tilt: 12.0 ± 4.7°
Carpal Bones ; Pathology ; Wrist

OBJECTIVE: The study aimed to describe portal stenting for postoperative portal occlusion with delayed (≥ 3 months) variceal bleeding in the afferent jejunal loop. MATERIALS AND METHODS: Eleven consecutive patients (age range, 2–79 years; eight men and three women) who underwent portal stenting between April 2009 and December 2015 were included in the study. Preoperative medical history and the postoperative clinical course were reviewed. Characteristics of portal occlusion and details of procedures were also investigated. Technical success, treatment efficacy (defined as disappearance of jejunal varix on follow-up CT), and clinical success were analyzed. Primary stent patency rate was plotted using the Kaplan-Meier method. RESULTS: All patients underwent hepatobiliary-pancreatic cancer surgery except two children with liver transplantation for biliary atresia. Portal occlusion was caused by benign postoperative change (n = 6) and local tumor recurrence (n = 5). Variceal bleeding occurred at 27 months (4 to 72 months) and portal stenting was performed at 37 months (4 to 121 months), on average, postoperatively. Technical success, treatment efficacy, and clinical success rates were 90.9, 100, and 81.8%, respectively. The primary patency rate of portal stent was 88.9% during the mean follow-up period of 9 months. Neither procedure-related complication nor mortality occurred. CONCLUSION: Interventional portal stenting is an effective treatment for delayed jejunal variceal bleeding due to portal occlusion after hepatobiliary-pancreatic surgery.
Biliary Atresia ; Child ; Esophageal and Gastric Varices ; Follow-Up Studies ; Hemorrhage* ; Humans ; Liver Transplantation ; Male ; Methods ; Mortality ; Portal Vein* ; Recurrence ; Stents* ; Treatment Outcome ; Varicose Veins*

OBJECTIVE: 1) To evaluate the mid-term efficacy and safety of a permanent nitinol inferior vena cava (IVC) filter; 2) to evaluate filter effectiveness, filter stability and caval occlusion. MATERIALS AND METHODS: A prospective evaluation of the TrapEase IVC filter was performed on 42 patients (eight men, 34 women) ranging in age from 22 to 78 years (mean age 66 years). All patients were ill with a high risk of pulmonary embolism (PE). Indications for filter placement were: 1) deep vein thrombosis with recurrent thromboembolism; 2) and/or free-floating thrombus with contraindication to anticoagulation; and 3) complications in achieving adequate anticoagulation. Follow-up evaluations (mean: 15.4 months, range: 2 to 28 months) were performed at 6- and 12-month intervals after the procedure and included clinical histories, chart reviews, plain film, Doppler ultrasounds, and contrasted abdominal CT scans. RESULTS: In follow-up evaluations, the data analysis revealed no cases of symptomatic PE. There were no cases of filter migration, insertion site thrombosis, filter fracture, or vessel wall perforation. During the study, there was one case of filter thrombosis; early symptomatic thrombosis that was successfully treated in the hospital. Of the 42 subjects, eight died. These deaths were not related to the filter device or the implantation procedure, but to the underlying disease. CONCLUSION: This study demonstrates that the TrapEase permanent IVC filter is a safe and an effective device with low complication rates and is best used in patients with thromboembolic disease with a high risk of PE.
Adult ; Aged ; *Alloys ; Equipment Design ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Prospective Studies ; Pulmonary Embolism/*prevention & control ; Safety ; Thromboembolism/complications ; Treatment Outcome ; *Vena Cava Filters ; Vena Cava, Inferior ; Venous Thrombosis/*complications

OBJECTIVE: To present our experience with subintimal angioplasty (SA) for treatment of chronic lower limb ischemia (CLLI) and to assess its effectiveness and durability. MATERIALS AND METHODS: From April 2003 through June 2005, we treated 40 limbs in 36 patients with CLLI by SA. Balloons with or without secondary stent placement appropriate in size to the occluded arteries were used for SA of all lesions, except for iliac lesions where primary stent placement was done. The patients were followed for 1-23 months by clinical examination and color Doppler ultrasound and/or CT angiography. Technical results and outcomes were retrospectively evaluated. The presence of a steep learning curve for performance of SA was also evaluated. Primary and secondary patencies were determined using Kaplan-Meier analysis. RESULTS: Technical success was achieved in 32 (80%) of 40 limbs. There was no statistical difference between technical success rates of 75% (18/24) during the first year and 88% (14/16) thereafter. There were four complications (10%) in 40 procedures; two arterial perforations, one pseudoaneurysm at the puncture site, and one delayed hematoma at the SA site. Excluding initial technical failures, the primary patency rates at six and 12 months were 68% and 55%, respectively. Secondary patency rates at six and 12 months were 73% and 59%, respectively. CONCLUSION: Subintimal angioplasty can be accomplished with a high technical success rate. It should be attempted in patients with CLLI as an alternative to more extended surgery, or when surgical treatment is not recommended due to comorbidity or an unfavorable disease pattern.
Tunica Intima/pathology ; Stents ; Middle Aged ; Male ; Leg/*blood supply ; Ischemia/epidemiology/*surgery ; Intermittent Claudication/surgery ; Humans ; Female ; Feasibility Studies ; Constriction, Pathologic ; Comorbidity ; Chronic Disease ; Angioplasty, Balloon/*methods ; Aged, 80 and over ; Aged