Previous applications of laser bone and cartilage ablation have focused largely on the CO2 and the Nd:Yag lasers, using both the continuous wave and rapid superpulsed mode, which revealed severe thermal damage such as tissue necrosis and carbonization of the remaining tissue. In contrast, Excimer lases have provided better histologic results with minimal or no thermal damage, but the ablation rate and cutting efficiency have remained unsatisfactory. Though arthroscopic partial menisectomy has become the accepted technique for dealing with tears in menisci, division of the meniscus is sometimes difficult in the confined joint space of the knee and is associated with iatrogenic injury to the articular cartilage. The ability to quickly and safely divide or remove meniscal tissue would be a distinct advantage. The Holmium:Yag laser has many potential advantages over the CO2 laster, the Nd:Yag laser and the Excimer laser. Its principal advantages include minimal mechanical trauma to the articular cartilage, greater access to tight or restricted area of the knee joint, and its ability to function in a saline medium and to resect meniscus with minimal tissue necrosis. We have evaluated the effectiveness of the Holmium:Yag laser 74 partial menisectomies of 57 patients. Among 74 meniscal tears, there were 35 medial and 39 lateral meniscal tears. The average operation time was 33 minutes in the menisectomy and hospital stay was average 3 days. There was no significant carbonization on the surrounding tissue. Menisectomy of the posterior horn was safe and easy and there was minimal iatrogenic articular cartilage damage.
Animals ; Carbon ; Cartilage ; Cartilage, Articular ; Holmium ; Horns ; Humans ; Joints ; Knee ; Knee Joint ; Lasers, Excimer ; Lasers, Solid-State ; Length of Stay ; Necrosis ; Tears

Idiopathic thrombocytopenic purpura is an uncommon illness but most common form of thrombocytopema in pregnancy. Corticosteroids, splenectomy, immunosuppressive drugs, and immunoglobulin therapy have been recommended for manaaement. The optimal method of delivery is controversial. We have experienced a case of idiopathic thrombocytopenic purpura diagnosed previously and managed with corticosteroid and vincrstine, which was followed by pregnancy, vaginal delivery and postpiirtum splenectomy.
Adrenal Cortex Hormones ; Immunization, Passive ; Pregnancy* ; Purpura, Thrombocytopenic, Idiopathic* ; Splenectomy

Linear porokeratosis is a rare variant of porokerstosis and usually occurs after childhood. We report herein a case of linesr porokeratosis in an 18-year-old female. The lesions had developed since birth and were found on the nearly whole body, including the face, neck, axilla, chest, abdomen, back, and upper and lower extremities. Palms and soles were also affected. Biopsy specirnens from the left forearm and right sole showed typical cornoid lamellae. We could not see any improvement with a course of oral etretinate for 6 weeks.
Abdomen ; Acitretin ; Adolescent ; Axilla ; Biopsy ; Etretinate ; Female ; Forearm ; Humans ; Lower Extremity ; Neck ; Parturition ; Porokeratosis* ; Thorax

Lichen sclerosus et atrophicus (LSA) is an uncommon condition of the skin with small white macular or atrophic plaques which predominantly affects the genital regions of middle aged and elderly women. We present an atypical case of LSA on a 58 year old woman. The patient had a brownish-black colored patch of 2.5 * 7.0 cm in size on the right clavicular area of one year's duration. The histopatholgy of the lesion disclosed classical findings of LSA. A marked incontinence of pigment is noted in the upper dermis which accounts for the clinical picture of the lesion. She was treated with topical hydrocortisone cream resulting in a marked diminution of pigmentation.
Aged ; Dermis ; Female ; Humans ; Hydrocortisone ; Lichen Sclerosus et Atrophicus* ; Lichens* ; Middle Aged ; Pigmentation ; Skin

No abstract available.
Arthritis* ; Osteoarthritis* ; Transforming Growth Factor beta* ; Transforming Growth Factors*

Alveolar Process ; Maxilla ; Osteotomy

Child ; Child, Preschool ; Cleft Lip ; Cleft Palate ; Congenital Abnormalities ; Consensus ; Humans ; Infant ; Leukocyte Count ; Male ; Palate ; Surgery, Oral

Confluent and reticulate papillomatosis is a rare but clinically distinct dermatosis first described by Gougerot and Carteaud in 1927. It consists of dark brown pigmented papules which coalesce to reticulate and confluent patches. It usually begins shortly after puberty mainly in females and is most often localized to the intermammary and interscapular regions. Histological examination shows hyperkeratosis and papillomatosis, and there may be decreased granular cell layer, focal acanthosis, or hypermelanosis of the basal cell layer. We recently observed a 20-year-old male patient who showed typical clinical and histopathological findings of confluent and reticuIate papillomatosis. Treatment with an aromatic analog of vitamin A acid(Ro 10-9359) resulted in dramatic effectivenese.
Adolescent ; Female ; Humans ; Hyperpigmentation ; Male ; Papilloma* ; Puberty ; Skin Diseases ; Tretinoin* ; Vitamin A* ; Vitamins* ; Young Adult

In order to evaluate the clinical usefulness of maternal serum C-reactive protein measurement in early detection of infectious morbidity at term laboring women, serum C-reactive protein levels were measured in 521 healthy pregnant women : 64 who were not in labor before term, 55 who were in labor before term, 71 who were not in labor at term and 331 who were in labor at term. The frequencies of elevated serum C-reactive protein level were compared in relation to the gestational weeks, the presence or absence of labor, the status of amniotic membranes and the degree of cervical dilation. The obtained results were as follows. 1. The frequencies of women with elevated serum C-reactive protein, 0.8 mg/dl or higher and 2.9 mg/dl or higher, in 521 health pregnant women were, 12 % and 4 %, respectively. 2. C-reactive pretein levels of 0.8 mg/dl or higher were more frequent in the group of women in labor than those not in labor(5. 93 %, vs, 13.73 %, p<0.05), but the frequencies of C-reactive protein level of 2.0 mg/dl or higher were not statistically different between both groups. The frequencies of C-reactive protein level of 0.8 mg/dl or higher and 2.0 mg/dl or higher were not statistically different between the groups before term and at term, intact and ruptured membranes, latent phase and active phase of labor, respectively. 3. Before term, C-reactive protein levels of 0.8 mg/dl or higher and 2.0 mg/dl or higher were more frequent in the group of women in labor than those not in labor(23.64 vs. 4.69, p<0.001 and 12.73% vs. 3.13%, p<0.05, respectively), but those statistical differences were not seen between both group at term. Above results and review of literature suggest that serum C-reactive protein level of 2.0 mg/dl or higher may be reliable in early detection of infectious morbidity at term laboring women as well as laboring women before term, and the presence of subclinical infection should be suspected in the laboring women before term with serum C-reactive protein level of 0.8 mg/dl or higher.
Amnion ; Asymptomatic Infections ; C-Reactive Protein* ; Female ; Humans ; Membranes ; Pregnant Women

No abstract available.
Anemia, Hypoplastic, Congenital*