Angiomyxolipoma is a rare variant of lipoma, which is described by Mai, 1996, at first. The nine cases of which have been reported to date. Microscopically, the lesion consists of adipose tissue with the paucicellular myxoid areas and fat tissue with numerous thin, dilated, and congestive blood vessels. The reported cases mostly located to the superficial layer on the scalp, subungual, extremities in adults. We report one case of angiomyxolipoma located in the submuscular and parosteal area in the distal femur around knee joint in a child.
Adipose Tissue ; Adult ; Blood Vessels ; Child ; Estrogens, Conjugated (USP) ; Extremities ; Femur ; Humans ; Knee Joint ; Lipoma ; Scalp

PURPOSE: This study compared the results between PFN (Proximal Femoral Nail) and DHS (Dynamic Hip Screw)in the treatment of a peritrochanteric fracture of the proximal femur. MATERIALS AND METHODS: 33 patients with peritrochanteric fractures treated with PFN for a minimum follow-up of at least 12 months were analyzed retrospectively. The patients with PFN group (n=33, group I) were taken from operations between Jan. 2003 and Dec. 2004, and the DHS group (n=34, group II) were used as the control group. Both groups were compared with regard to the operation time, blood loss, transfusion, ICU care, drain amount, duration of admission, complications, the neck shaft angle, the sliding length of lag screws, radiological union, and the functional recovery grade using Jensen and Palmar and Parker's method. RESULTS: The mean operative times were 105 (group I) and 157 minutes (group II), blood losses were 540 and 840cc, transfusion volumes were 1.5 and 2.2 pints, ICU care was 6 and 30%, drain amounts were 36 and 203 cc, admission duration was 25 and 33 days, complications were 15 and 17%, reoperations by the failure of the reduction were 2 cases(6%) (group I) and 0 (group II), difference in the neck shaft angles were 3.70 and 3.87degrees, sliding length of the lag screws were 1.9 and 6.9 mm, radiological union was achieved in 17.5 and 18.9 weeks, function scores were 1.81 and 1.94, and the mobility scores were 6.51 and 6.16, respectively. These results show that there were advantages of PFN in terms of the operative times, blood loss, transfusion, ICU care, drain amounts, admission duration, sliding length of the lag screws and radiological union with statistical significance (p<0.05). CONCLUSION: Good clinical results can be achieved with PFN compared with the DHS for the treatment of peritrochanteric fractures of the proximal femur.
Femur* ; Follow-Up Studies ; Hip* ; Humans ; Neck ; Operative Time ; Retrospective Studies

Inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase, known as statins, are widely used for primary and secondary prevention of coronary artery atherosclerosis. Pathogenesis of atherosclerosis is multistep processes where transendothelial migration of various leukocytes including monocytes is a crucial step. Interferon-gamma(IFN-gamma) contributes in this process by activating macrophages and T-lymphocytes, and by inducing adhesion molecules in vascular endothelial and smooth muscle cells. In this study we investigated the expression of intercellular cell adhesion molecule- 1 (ICAM-1) in transformed endothelial cell line ECV304 cells as influenced by lovastatin, tumor necrosis factor-alpha (TNF-alpha) and IFN-gamma. Results show that lovastatin suppresses expression of ICAM-1 by inhibiting the IFN-gamma-induced extracellular signal-regulated kinase (ERK) p44/p42-STAT1 signaling pathway. In cells treated with lovastatin and IFN-gamma.ICAM-1 was expressed at a lower level than in cells treated with IFN-gamma alone. However, lovastatin does not reduce TNF-alpha induced expression of ICAM-1. A similar result was observed in cells treated with the MEKK inhibitor PD98059 and IFN-gamma. Cis-acting DNA sequence elements were identified in the 5'-flanking region of the ICAM-1 promoter that mediate inhibition by lovastatin; these sequences map to the IFN-gamma activated site which also binds the STAT1 homodimer. However, lovastatin did not inhibit IFN-gamma-mediated induction of the Y701 phosphorylated form of STAT1. But lovastatin does inhibit the IFN-gamma-mediated phosphorylation of ERK1/ERK2 (T202/Y204) and S727 phosphorylation of STAT1. TNF-alpha does not induce phosphorylation of ERK1/ERK2 and S727 in ECV304 and smooth muscle cells. The results provide the evidences that statins may have beneficial effects by inhibiting IFN-gamma action in atherosclerotic process
Animals ; Cell Line ; DNA-Binding Proteins/metabolism ; Endothelium, Vascular/cytology/*drug effects/metabolism ; Gene Expression Regulation/*drug effects ; Intercellular Adhesion Molecule-1/genetics/*metabolism ; Interferon Type II/*antagonists & inhibitors/*pharmacology ; Lovastatin/*pharmacology ; Mitogen-Activated Protein Kinases/metabolism ; Myocytes, Smooth Muscle/cytology/*drug effects/metabolism ; Phosphorylation/drug effects ; Promoter Regions (Genetics)/genetics ; RNA, Messenger/genetics/metabolism ; Rats ; Recombinant Proteins ; Trans-Activators/metabolism ; Tumor Necrosis Factor/pharmacology

BACKGROUND: It is known that propofol protects myocardium against a global ischemia-reperfusion injury in the isolated rat heart model. The aim of this study was to investigate whether propofol, at a clinically relevant concentration infused during the peri-ischemic period, also provides a protective effect against a regional myocardial ischemia-reperfusion injury in vivo. METHODS: Rats were subjected to 25 minutes of coronary artery occlusion followed by 24 hours of reperfusion. Propofol or intralipid was administrated during 35 minutes starting 5 minutes before the onset of ischemia until 5 minutes after the onset of reperfusion. A micromanometer catheter was advanced into the left ventricle and the hemodynamic function was evaluated. The infarct size was determined by triphenyltetrazolium staining after 24 hours of reperfusion. RESULTS: Propofol administration during the peri-ischemic period demonstrated protective effects on hemodynamic function and infarct size reduction. In the control group, the peak rate of the ventricular pressure increase (+dP/dt(max))(P = 0.0001) and the peak rate of the intraventricular pressure decline (-dP/dt(max))(P = 0.0001) were significantly decreased compared to the sham group. In the propofol group, the +dP/dt(max) (P = 0.003) and -dP/dt(max) (P = 0.002) were significantly improved compared to the control group. The infarct size was 47.6% of the area at risks in the control group, and was reduced markedly by administration of propofol during the peri-ischemic period to 26.2% in the propofol group (P = 0.004). CONCLUSIONS: Propofol, at a clinically relevant concentration infused during the peri-ischemic period, have protective effect after regional myocardial ischemia-reperfusion injury in an in vivo rat heart model.
Animals ; Catheters ; Coronary Vessels ; Emulsions ; Heart ; Heart Ventricles ; Hemodynamics ; Ischemia ; Myocardium ; Phospholipids ; Propofol ; Rats ; Reperfusion ; Reperfusion Injury ; Salicylamides ; Soybean Oil ; Tetrazolium Salts ; Ventricular Pressure

BACKGROUND/AIMS: Some clinical and laboratory parameter are predictors to determine steroid treatment failure in patients acute severe ulcerative colitis. We aimed to validate previous models in the Korean patients. METHODS: This study was conducted retrospectively with 70 patients who were diagnosed with severe ulcerative colitis (UC) between January 2001 and June 2011. The rate of treatment failure was investigated using predictors or numerical scoring systems from prior studies. RESULTS: Twelve (17.2%) patients failed to respond to steroid therapy. The logistic regression analysis revealed that stool frequency on the fifth day and colonic dilatation were the only independent predictive factors related to treatment failure. Formulated numerical risk scores based on mean stool frequency, colonic dilatation, and hypoalbuminemia were significantly higher in the non-responding group than those in the responding group (P<0.001). Using another scoring system (stool frequency on the third day+1.4xC-reactive protein [CRP]), treatment failure rate was significantly higher in the group in which the score was >8 than in the group with a score <8 (30.8% vs. 8.6%, P=0.042). Lastly, treatment failure rate was higher in the group (stool frequency >8 plus CRP >4.5 mg/dL or bloody stool plus CRP >4.3 mg/dL) than those of the other group at the third day (40% vs. 7.3%, P=0.004; 33.3% vs. 5.2%, P=0.014, respectively). CONCLUSIONS: Stool frequency and CRP level were the meaningful parameters among the predictors for steroid treatment response. Furthermore, several predictive models for steroid treatment failure in western countries seem to be of value for use in the Korean population.
Adrenal Cortex Hormones ; Colitis, Ulcerative ; Colon ; Dilatation ; Humans ; Hypoalbuminemia ; Logistic Models ; Retrospective Studies ; Treatment Failure ; Ulcer

Traumatic anterior dislocation of the hip is rare. Bilateral traumatic anterior dislocation is an even rarer injury; indeed, only 5 cases have been reported in the English literature. We describe a case of a bilateral traumatic anterior dislocation of the hip and a concomitant unstable lumbar burst fracture following a mechanism of injury distinctly different from other reports.
*Accidents, Occupational ; Acetabulum/injuries ; Buttocks/*injuries ; Fractures, Bone/complications/etiology/radiography ; Hip Dislocation/etiology/*radiography ; Humans ; Lumbar Vertebrae/*injuries ; Lumbosacral Region/*injuries ; Male ; Middle Aged ; Spinal Fractures/etiology/*radiography

PURPOSE: The purpose of this study is to evaluate the results of tension band wiring and additional circumferential wiring in treatment of comminuted patella fractures. MATERIALS AND METHODS: A retrospective study of 67 patients with follow-up period longer than six months who underwent tension band wiring and additional circumferential wiring for comminuted patellar fracture from January 2004 to December 2012 was conducted. Analysis was based on radiological evaluation of bony union and articular surface displacement, and clinically by evaluating the postoperative function of the knee joint using the Levack scoring system. RESULTS: Only one case out of 67 (1.5%) showed nonunion without metal breakage while good bone union was achieved in all other cases. Excluding the nonunion case, range of motion was 90 degrees minimum, 135 maximum, 129 on average. Average displacement was less than 2 mm, and 64 out of 67 cases showed satisfactory outcome with excellent functional score according to the Levack scoring system. CONCLUSION: Tension band wiring and additional circumferential wiring technique for treatment of comminuted patella fractures can be considered as an effective treatment for achievement of good bone union and restoration of normal knee function.
Follow-Up Studies ; Fractures, Comminuted ; Humans ; Knee ; Knee Joint ; Patella* ; Range of Motion, Articular ; Retrospective Studies

PURPOSE: To evaluate colonic transit time (CTT) in patients with spastic pelvic floor syndrome (SPFS)diagnosed by defecography and compare the findings with those of patients with normal defecography. MATERIALS AND METHODS: Over a recent 15-month period, 140 patients underwent both defecography and CTT test because of chronicidiopathic constipation. Of these, 54 with SPFS diagnosed by defecography and 49 controls with normal defecographywere included in our study. CTT testing involved the radiopaque marker method. Subjects ingested 24 markers at9:00AM on three consecutive days and a plain film of the abdomen was obtained on day 4. We calculated total andsegmental CTT, and compared CTT test findings in the two groups. RESULTS: Delayed total CTT was found in 35% ofpatients (19/54) with SPFS. Segmental CTT in the right, left and rectosigmoid colon was delayed in 19% (10/54),44% (24/54), and 31% of cases(17/54), respectively. Total CTT was delayed in 31% of patients(15/49) with normaldefecography. In this group, segmental CTT in the left colon was delayed in 39% of cases. CONCLUSION: There was nosignificant difference in CTT findings between the SPFS and normal groups on defecogram.
Abdomen ; Colon* ; Constipation ; Defecography ; Humans ; Muscle Spasticity* ; Pelvic Floor*

Brucellosis is a well known systemic, zoonotic disease that can affect many organs. We report a rare case of spondylodiscitis with an epidural abscess caused by brucellosis. The patient was treated surgically for severe pain and concomitant devastating neurological deficit. A diagnosis of spondylodiscitis or an epidural abscess due to brucellosis must be considered when acute back pain, radiating pain and febrile episodes occur, particularly in people in a high risk group.
Back Pain ; Brucellosis ; Discitis ; Epidural Abscess ; Humans

Lithium has been established as a drug useful for the treatment of manic depressive disorder. It is now well recognized that long-term administration of this drug is associated with various antithyroid effects such as goiter, and subclinical and overt hypothyroidism. However, it has been associated less commonly with thyrotoxicosis. Recently we experienced a case of thyroitoxicosis during lithium therapy. A 24-year-old man treated with lithium carbonate 900 mg-1,200 mg/day for manic-depressive illness for four weeks. He then complained of nervousness, palpitation, tremor, heat intolerance, and sweating. Neck pain was not noted. At that time the results of thyroid function test were consistent with hyperthyroidism: T3 568.8 ng/dL, TSH 0.01 mU/mL, FT4 6.0 ng/dL, but 24 hr radioiodine uptake was 0.3%. We suspected this case as lithium induced thyrotoxicosis and discontinued lithium administration. After discontinuation of lithium thyrotoxic symptoms were subsided. One month later, thyroid hormon levels became normalized: T 100.2 ng/dL, TSH 0.06 mU/mL, FT4 0.97 ng/dL and 24hr radioiodine uptake was 16%. We report this case with review of literatures.
Antithyroid Agents ; Anxiety ; Depressive Disorder ; Goiter ; Hot Temperature ; Humans ; Hyperthyroidism ; Hypothyroidism ; Lithium Carbonate ; Lithium* ; Neck Pain ; Sweat ; Sweating ; Thyroid Function Tests ; Thyroid Gland ; Thyrotoxicosis* ; Tremor ; Young Adult