PURPOSE: The aim of this study is to analyse the clinical characteristics and results of treatment of knee dislocation. MATERIALS AND METHODS: The 18 cases of the traumatic dislocation of knee were treated at Yeung-nam university hospital from 1991 Jan. to 1997 Apr. and those were followed more than one year after injury. Result: Anterior and posterior cruciate ligament were ruptured in all cases and the two thirds of the ruptured site of cruciate ligament was femoral attachment, Medial collateral ligament injury(13 cases) were more than lateral collateral injury(8 cases) and more than half cases of collateral ligament injury were rup- tured at tibial and fibular attachment. The functional result by Lysholm knee scoring revealed fair(81 score) in average and excellent in 3 cases, good in 5 cases, fair in 10 cases. Complications were limitation of motion in 6 cases, pain in 2 cases and nerve paraiysis in 1 case. CONCLUSION: Applying classification system according to direction of displacement is sometimes difficult because the dislocation of knee could be transferred after reduction. It was thought that another subclassifica- tion system in terms of ligaments involved should be used. Functional results by Lysholm knee scoring revealed fair(81 score) in average. Early range of motion should be started after surgical repair and minimal immobilization to avoid limitation of knee motion.
Classification ; Collateral Ligaments ; Dislocations* ; Immobilization ; Knee Dislocation ; Knee* ; Ligaments ; Posterior Cruciate Ligament ; Range of Motion, Articular

In the correction of congenital blepharoptosis, there are banked fascia lata, silicone band or rod, palmaris longus tendon, Gore-Tex, Mersilene, Supramid and etc. used for frontalis suspension. A retrospective study on the results and recurrences of 63 patients[79 eyes] who were diagnosed as congenital blepharoptosis and received frontalis suspension with Supramid Extra II(r) from Jan.1994 to Dec.1998. was done. The patients were consisted of 36 males and 27 females and the average age at the time of operation was 18 months[3.5 months~58 months]. The postoperative results were satisfactory in all the patients, yet recurrence was found in 26 patients between 4.5 months and 56 months after surgery. The results of 48 patients who could be followed up for over a year showed a 52%[25 patients] recurrence rate with a mean follow-up time of 41.3 months. The mean recurrence time was 30.7 months after operation. The use of Supramid Extra II(r) in frontalis suspension has benefit such as easy availability and favorable handling characteristics, but due to its high recurrence rate, it prompts the need for patient education and a follow-up period of over 4 years.
Blepharoptosis* ; Fascia Lata ; Female ; Follow-Up Studies ; Humans ; Male ; Nylons* ; Patient Education as Topic ; Polytetrafluoroethylene ; Recurrence ; Retrospective Studies ; Silicones ; Tendons

To investigate results of treatment with essential blepharospasm, patients were evaluated by results of treatment with botulinum toxin A and myectomy operation. Seventy patients of the essential blepharospasm who received local injection of botulinum toxin or orbicularis muscle extirpative surgery were evaluated according to results and complications of the treatment modality over a 7-year period. Fifty-six patients[80%] were primarily treated with botulinum toxin and 14 patients[20%] underwent myectomy operation as the primary treatment. Of the 56 patients, 8[14.3%] were treated later with myectomy operation. In botulinum toxin treatment, the mean subjective improvement was found in 89.2% of the patients, and the mean effective durations of essential blepharospasm were 12.7 weeks. Severity and frequency grades in eyelid spasm were significantly lower after injection[P=.000]. Tearing, dry eye, and headche were the most frequent complications and ptosis was observed in 2 cases[2.0%]. In the orbicularis myectomy operation, 13 patients[59.1%] were carried out through a brow incisions, 1[4.5%] through a blepharoplasty incisions, and 8[36.4%] through both. Fourteen patients[63.6%] had acceptable control of blepharospasm throughout follow-up after the upper lid orbicularis stripping procedure alone. We believe that botulinum toxin is the treatment of first choice because of its higher acceptance rate. Surgery is reserved for botulinum toxin failure. In otherwise fit patients, myectomy is the treatment of first choice.
Blepharoplasty ; Blepharospasm* ; Botulinum Toxins* ; Eyelids ; Follow-Up Studies ; Humans ; Spasm

Occurrence of a retroperitoneal duplication cyst associated with a heterotopic pancreas is rare. We report a case of a retroperitoneal duplication cyst associated with a heterotopic pancreas. A 35-year-old male was admitted, presenting with back pain. A pelvic computed tomographic scan disclosed a 10 cm-sized cystic mass filling the lower pelvis and displacing the rectosigmoid colon anteriorly. Histologically, the cyst wall was lined partly by mucin-secreting columnar epithelium, showing atypical hyperplasia and partly by a gastric fundic-type and a colonic-like mucosa. Beneath the epithelium, organized bundles of smooth muscle were arranged in two layers analogous to smooth muscles layers of the bowel and a small piece of pancreatic tissue were present in the smooth muscle wall of the cyst.
Adult ; Back Pain ; Colon ; Epithelium ; Humans ; Hyperplasia ; Male ; Mucous Membrane ; Muscle, Smooth ; Pancreas* ; Pelvis

Primary meningeal melanocytoma of the central nervous system is extremely rare. We report a case of meningeal melanocytoma associated with Ota's nevus as a recurrent form in a 53-year old male. The meningeal melanocytoma was removed from right parietooccipital lobe 4 years ago and recurred in right parietal, occipital and left frontal lobes. Ultrastructurally, the tumor cells were characterized by the presence of numerous melanosomes and premelanosomes in their cytoplasm. Moreover, the tumor was lacking in histologic and ultrastructural features of pigmented meningioma, melanotic schwannoma and prolonged clinical course was different from primary meningeal melanoma or metastatic malignant melanoma.
Neoplasm Metastasis

BACKGROUND/AIMS: This study was aimed to examine if FB1 induced-hepatotoxicity involves apoptosis, and cholesteryl hemisuccinate (CS) pre-treatment would selectively interfere with FB1 induced-apoptosis of hepatocytes. METHODS: Sprague-Dawley rats were intravenousely injected with FB1 (1.25 mg/kg/day) for two days, and were sacrificed at 3, 6, 12, 24 and 48 hours after injection. Another experiment group was composed of rats with pretreatment of CS (100 mg/kg/day, i.p.) before FB1 injection. RESULTS: This study demonstrated that administration of hepatotoxic dose of FB1 to Sprague-Dawley rats resulted in liver injury leading to cell death by apoptosis. FB1-induced apoptosis was preceded by early elevation in serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), total cholesterol, and appearance of injured pre-apoptotic cells at 12 hours was followed by massive fragmentation and margination of heterochromatin at 24 hours. CS pre-treatment prior to FB1 injection ameliorated serum biochemistry and hepatic injury with apoptosis, demonstrated by histological, ultrastructural and TUNEL (terminal deoxyribonucleotidyl transferase-mediated dUTP-digoxigenin nick end labeling) methods. In addition, there was remarkable decrease in number of PCNA (proliferative cell nuclear antigen)-positive proliferating hepatocytes compared to that of FB1 treated group. CONCLUSION: This study suggests that apoptosis significantly contributes to FB1-induced hepatotoxicity in vivo, and pre-exposure of rat to CS prevents FB1-induced hepatic apoptosis and proliferation.
Alanine Transaminase ; Animals ; Apoptosis* ; Aspartate Aminotransferases ; Biochemistry ; Cell Death ; Cholesterol ; Hepatocytes* ; Heterochromatin ; In Situ Nick-End Labeling ; Liver* ; Proliferating Cell Nuclear Antigen ; Rats* ; Rats, Sprague-Dawley

Carcinoid tumors of the appendix are common incidental findings, but appendiceal tumors with histologic features of both carcinoids and adenocarcinomas are rare, and their biologic behavior and histogenesis are still unclear. We report a case of goblet cell carcinoid of the appendix in a 54-year-old male, who exhibited pain in the right lower abdomen. Microscopically, the tumor contained smooth-bordered, widely separated nests composed of tumor cells with abundant mucin. The principal tumor cell type had a close resemblance to the normal goblet cell. Histochemically, the tumor cells revealed positive reaction for PAS and alcian blue stain. Immunohistochemically, the tumor showed strong reactivity for carcinoembryonic antigen, chromogranin and, neuron specific enolase but none for cytokeratin and epithelial membrane antigen.
Adenocarcinoma

A case of left parietal pleomorphic xanthoastrocytoma that occurred in a 58-year-old woman is reported clinicopathologically. Histopathologic diagnosis of pleomorphic xanthoastrocytoma was made because of the unique pleomorphic histologic features, positive glial fibrillary acidic protein in immunohistochemical staining. The flow cytometric analysis reveals DNA aneuploidy and relatively high S-phase fraction. The pleomorphic xanthoastrocytoma is considered as a special subgroup of glioma on the basis of superficial cortical location, GFAP expression, marked cellular atypia, xanthomatous cells, and relatively favorable prognosis.
Female ; Humans

Eccrine spiradenomas are clinically characterized by a solitary, tender mass and they are situated on the upper parts of the body, predominantly on the ventral aspect. We herein report two cases of eccrine spiradenoma in 35-year-old man and 53-year-old woman, which located on upper extremity and inguinal region. The masses are round, well circumscribed and measuring 0.7x0.5x0.5 cm, 5x4.5x3 cm in size, respectively. Histopathologically, the tumor consists of masses of two types of cells, intensely staining cells and pale staining cells, usually arranged in chains, cords and pseudoglands. Immunostainings for low molecular cytokeratin, high molecular cytokeratin, carcinoembryonic antigen, and S-100 protein show positivity in neoplastic cells. Electron microscopically, the tumor was composed of three types of cells, i. e. 1) round or ovoid tumor cells in shape with scanty cytoplasm and poorly developed intracytoplasmic orgenelles, 2) spindle shaped dark cells interconnected by desmosomes, 3) large epithelial cells with abundant cytoplasm and cytoplasmic intermediate filaments which formed glandular structures. The large epithelial cells joint each other by desmosomal attachments and luminal cells featured small numbers of microvilli, but either secretory granules nor ductal type granules were noticed.
Female ; Male ; Humans

Lymphocytic hypophysitis is an autoimmune disorder of the pituitary gland which usually occurs in a woman in the postpartum period. Diabetes insipidus is not a major clinical feature of this disorder. We report a case of a 22-year-old man with lymphocytic hypophysitis which presented with diabetes insipidus and also involved his cavernous sinus. This represents the seventh reported and the youngest case of a man with lymphocytic hypophysitis. A comparative study of all six male patients is also presented. We suggest diabetes insipidus should be added to the spectrum of clinical manifestations of this disorder.
Female ; Male ; Humans