No Abstract Available.
Leukemia* ; Leukemic Infiltration* ; Skin*

Ganglia are the most common soft tissue tumors of the hand. Ganglia found on the dorsum of the wrist usually arise from the scapholunate ligament and are usually located between the extensor digitorum communis tendon of the index finger and extensor pollicis longus tendon. Intratendinous ganglion is a very rare lesion of unknown etiology and natural history that originates within the tendon. A patient is described who presented with a painful mass on the dorsolateral aspect of the wrist due to an intratendinous ganglion of the extensor pollicis longus tendon. Treatment consisted of excision of the extensor pollicis longus tendon with ganglion followed by mini free tendon graft using palmaris longus tendon.
Fingers ; Ganglia ; Ganglion Cysts ; Hand ; Humans ; Ligaments ; Natural History ; Tendons ; Transplants ; Wrist

We report a case of actinic granuloma in a 39 year-old woman who was presented with multiple anetoderma on non-sun exposed skin such as the neck, upper arms, elbows and calfs. The anetodermic presentation of actinic granuloma has never been reported and the common pathogenesis involving reduction of elastic fibers link the two disorders. Anetoderma secondary due to actinic granuloma should to be included in the list of secondary anetoderma and may suggest one of the possible pathogenesis of anetoderma.
Actins* ; Adult ; Anetoderma* ; Arm ; Elastic Tissue ; Elbow ; Female ; Granuloma* ; Humans ; Neck ; Skin

Neurofibromatosis is a complex hereditary disease involving many organs and systems. The incidence in pregnancy is less frequent and has been reported as 1/5000 to 1/18500 deliveries. Therefore, little is known about the interactions between neurofibromatosis and pregnancy. A survey of relevant literature suggests that patients with NF have an increased risk of perinatal complications (pregnancy induced hypertension, IUGR, preterm labor, abortion, stillbirth, high cesarean section rate) and maternal disease aggravation (rupture of an aneurysm, sarcomatous degeneration of neurofibroma, activation of pheochromocytoma). Refined ultrasound, flow studies and fetal monitoring allow us to provide improved pregnancy care for neurofibromatosis. However, It should be remembered that even now, neurofibromatosis places pregnant women and their fetuses in a high risk group with the potential to develop life threatening complications. We report a case of vertebral artery aneurysm and preeclampsia complicating a pregnancy with neurofibromatosis."
Aneurysm* ; Cesarean Section ; Female ; Fetal Growth Retardation ; Fetal Monitoring ; Fetus ; Genetic Diseases, Inborn ; Humans ; Hypertension ; Incidence ; Neurofibroma ; Neurofibromatoses* ; Neurofibromatosis 1 ; Obstetric Labor, Premature ; Pre-Eclampsia* ; Pregnancy* ; Pregnant Women ; Stillbirth ; Ultrasonography ; Vertebral Artery*

No abstract available.

Epithelioid hemangioendothelioma(EH) is a low-grade tumor of vascular endothelial cell origin, which most commonly occur in the lower extremities of middle-aged patients with an equal gender distribution. It may occur on internal organs such as the liver or lung or bones. A 54-year-old woman who had a history of metastatic adenocarcinoma of unknown origin on the right inguinal lymph node, was presented to us because of a 1.0 x 1.0cm-sized and 2 x 2cm-sized two subcutaneous nodule on her right shin. On H & E stain, there were nests of round nucleated, polygonal, vacuolated cells, some of which contained fragmented erythrocytes. Factor VIII related antigen, CD31 was positive. A diagnosis of epithelioid hemangioendothelioma was established based on histologic, immunohistochemical studies. Wide excision was performed. There was no recurrence nor the development of new lesions so far.
Adenocarcinoma ; Diagnosis ; Endothelial Cells ; Erythrocytes ; Female ; Hemangioendothelioma, Epithelioid* ; Humans ; Liver ; Lower Extremity ; Lung ; Lymph Nodes ; Middle Aged ; Recurrence ; von Willebrand Factor

Neurocutaneous melanosis is a very rare congenital syndrome characterized by the presence of large or multiple congenital melanocytic nevi and benign or malignant melanotic tumors of the central nervous system. We report herein a case of neurocutaneous melanosis with leptomeningeal melanosis and a malignant melanoma of the right temporal lobe in a 46-year old man. The case is exceptional as regards the late onset of symptoms and death. Even without a malignant melanoma, the symptomatic neurocutaneous melanosis has a fatal course. The syndrome is rare but lethal, so the dermatologist should be aware of this syndrome when evaluating the patients with large or numerous congenital melanocytic nevi so as to watch for the usual signs of increased intracranial pressure and to take prompt palliative measures.
Central Nervous System ; Humans ; Intracranial Pressure ; Melanoma ; Melanosis* ; Nevus, Pigmented ; Temporal Lobe

For more than 80% of body weight is transmitted through the anterior and middle column, the interbody gap produced by operative reduction of spondylolisthesis is potential risk factor for redisplacement, implant failure, pseudoarthrosis and kyphosis. In biomechanical aspect, augmentation of the anterior column support by interbody fusion is desirable to prevent above problems in surgical treatment of spondylolisthesis. Recently, circumferential fusion is recommended in high-grade spondylolisthesis (grade III, IV, or V ), but there is some controversy about additional interbody fusion in posterior instrumentation for low-grade spondylolisthesis (grade I or II ). So, the purpose of this retrospective study was to compare the segmental sagittal angle in 35 patients of low-grade spondylolisthesis who was performed posterior instrumentation with or without posterial lumbar interbody fusion (PLIF) and to find out the risk factors of the loss of segmental sagittal angle in cases of posterior instrumentation without posterial lumbar interbody fusion (PLIF).
Body Weight ; Humans ; Kyphosis ; Pseudarthrosis ; Retrospective Studies ; Risk Factors ; Spondylolisthesis*

The anterior decompression and anterior interbody fusion have been the choice of surgical treatment for spinal tuberculosis since 1960. But, multi-level spinal tuberculosis involved more than three vertebrae resulted in large post-debridement defect and spinal instability. So, failure of the graft was very common & postoperative maintenance of the kyphotic angle correction was very difficult. In part of such cases as multi-level spinal tuberculosis, we performed supplementary anterior instrumentation in a single-stage procedure. The authors analyzed total 39 surgical cases of multi-level tuberculosis of the thoracolumbar spine from January 1985 to June 1992. The patients treated only with a strut graft were designated as group I(n=23) and the patients added by anterior instrumentation as group II(n=16). Mean age of 39 cases was 33.1 years, and mean follow-up period was 31.6 months. The purpose of this study was to compare the postoperative results of group I with those of group II by measuring the angular kyphosis on serial lateral roentgenograms, and to provide an aid in selecting method of surgery before treatment of multi-level spinal tuberculosis with high risk of progression of kyphosis. The results were as follows: 1. There were 16 cases of thoracolumbar, 14 cases of thoracic, 9 cases of lower lumbar lesions, and numbers of vertebrae involved were 4.2 in mean. 2. By standard Cobb lateral measurement, mean preoperative angle of segmental kyphosis was 32.5° in group I, and 45.1° in group II, and group II proved as more kyphotic. After operation, mean angle of segmental kyphosis was 24.7° in group I and 32.4° in group II. 3. On final F/U, mean angle of segmental kyphos was 32.7° in group I, and 37.3° in group II, and final loss of correction was 8.0° in group I, 4.9° in group II. 4. There were 8 patients(34.8%) of graft-related complications in Group I, and 2(12.5%) in group II. And graft failure in group I resulted in severe loss of correction of segmental kyphosis, but graft failure in group II did not, through graft protection by anterior instrumentation. 5. There were 3 patients(18.8%) of implant-related problems in group II; two during and one after union. In these former two cases, bony union was obtained without loss of correction by prolonged application of brace. No cases of group II was associated with persistence or recurrence of infection after instrumentation. In our opinion, anterior interbody fusion and combined anterior instrumentation can be effective and safe one of methods in surgical treatment for multi-level tuberculosis of the spine which has been considered as the most important determinant of the result by its extensive vertebral involvement with resulting large post-debridement defect to be struted.
Braces ; Decompression ; Follow-Up Studies ; Humans ; Kyphosis ; Methods ; Recurrence ; Spine ; Transplants ; Tuberculosis ; Tuberculosis, Spinal

Vertebral stabilization using transpedicular screw fixation device is widely used in the surgical treatment of degenerative lumber diseases such as spinal stenosis, pseudospondylolisthesis, and spinal instability. The use of transpedicular screw fixation devices provides substantial advantages with regard to an increase of the rate of solid arthrodesis, early rehabilitation, short segment spinal fusion, and restoration of sagittal lumbar lordosis. The authors analyzed 11 patients showing definite postoperative loss of the lumbar sagittal lordosis in a total of 110 surgical cases of degenerative lumbar diseases who underwent segmental spinal fusion using transpedicular screws from January 1981 to December 1993. The purpose of this study was to analyze the causes of loss of lumbar sagittal lordosis in the instrumented segments and to present some precautions in transpedicular screw fixation for surgical patients with degenerative lumbar spines to maintain corrected lumbar sagittal lordosis. The results from this study were as follows: 1. By standard Cobb lateral measurements, eleven cases in a total of 110 patients showed definite loss of lumbar sagittal lordosis more than 4 degrees. 2. The period reflecting loss of lordosis was roughly within postoperative four months which were critical fusion time of the grafted bone mass, which lasted an average of 4.8 months in this study. 3. The implants led to loss of lordosis consisted of 6 cases in 53 Diapasons, 4 cases in 32 Wiltses, and a case in 15 Steffee plate systems. Diapason & Steffee plate systems were classified as a rigid type and Wiltse system as a flexible one. 4. The causes of postoperative loss of lordosis were recognized as 2 cases of screw toggling, 5 cases of screw-rod locking failure and 4 cases of rod bending. 5. The group resulted in more loss of lordosis in degrees was related to significant change between preoperative and postoperative lordosis, distraction of disc space during operation, extensive discectomy, and reduction of degenerative spondylolisthesis which were the cases of the anterior column deficiency.
Animals ; Arthrodesis ; Diskectomy ; Humans ; Lordosis ; Rehabilitation ; Spinal Fusion ; Spinal Stenosis ; Spine ; Spondylolisthesis ; Transplants