The fabella, which means little bean is a sesamoid bone located in the lteral head of the gastrocnemius muscle. It has been estimated from radiographic studies, that fabella presents in 11.5%-12.9% of adult knees, and bilaterally in more than 50% of the adult population. The salient features of the fabellar syndrome includes intermittent pain in the posterolateral region, accentuated by knee extension and localized tendemess caused by compression against the femoral condyle. We experienced a case of fabella impingement syndrome which includes symptom of intermittent pain in the posterolateral region, intermittent locking and limitation of knee motion, gd report with review of literatures where it has not ever been introduced.
Adult ; Head ; Humans ; Knee ; Muscle, Skeletal ; Sesamoid Bones

Two cases of Dandy-Walker syndrome are reported with emphasis on CT findings. The Dandy-Walker syndrome is known to be a developmental anomaly, which is a congenital cystic dilatation of the fourth ventricle due to atresia of foramen Magendie and possibly also foramen Luschka, associated with some form of vermian dysgenesis. The CT findings of one case reveal huge cystic mass in midline of the posterior cranial fossa with small compressed cerebellar hemisphere in the lateral portion, associated with hydrocephalus. The other shows semilunar-shaped cystic mass in posterior cranial fossa with anteriorly displaced cerebellum, which communicates with apparent fourth ventricle through the vallecula. Both cases show no inferior.
Cerebellum ; Cranial Fossa, Posterior ; Dandy-Walker Syndrome ; Dilatation ; Fourth Ventricle ; Hydrocephalus

Generally, exposure and the operative technique are common difficulty encountered in the total knee arthroplasty of ankylosed knee due to old infection sequelae. Also the postoperative range of motion and relief of pain is poor due to deformity and excessive soft tissue contracture around knee. There have heen few reports, however, that address the reconstructive challenge of total knee arthroplasty in a previously infected ankylosed knee. We perfoined TKA in thirty six patients who had ankylosed knee between July l986 and Dec. 199S. After follow up of average five years and one month, we analysed the results. The definition of ankylosis was a knee ROM less than 90 degree. Average age of patients were 36.7 years old. Twelve patients were meii and twenty four patients were women. Sixteen patients of partial ankylosis and twenty patients of complete ankylosis were performed operation. There were nineteen cases of healed tubercuiosis knees and seventeen cases of healed pyogenic knees. For the release of soft tissue contracture in 9 cases, we lengthened quadrceps tendon with the method of modified V-Y advancement technique. Patella tendon was proximally reattached with staples and suture in 6 cases and tibial tubercle was proximally transferred in 3 cases. As results, the postoperative average range of motion was 79.3 (30 - l21') in complete ankylosis, 107 (60 - 135 ) in partial ankylosis. The average Hospital for Speciai Surgery knee rating score improved from 56.3 points preoperatively to 84.8 points postoperatively. Radiolucent line was observed in two Knees with less than 2mm width in three years and four months, and four years postoperatively, hut the patient had no pain. In five patients who had poor gain of range of motion after operation, we perfonned arthroscopic adhesiolysis. In conclusion, regarding patient selection, reasonable hony development, relative]y healthy extensor mechanism and adequate soft tissue condition are important for success of TKA in old intection sequelae. TKA of ankylosed knee in old infection sequelae is a successful procedui which can ohtain the restoration of function of the ankylosed knee.
Ankylosis ; Arthroplasty* ; Congenital Abnormalities ; Contracture ; Female ; Follow-Up Studies ; Humans ; Knee* ; Patellar Ligament ; Patient Selection ; Range of Motion, Articular ; Sutures ; Tendons

Hydrocephalus is a common malformation of the central nervous system and its cause may be either congenital or acquired. The imbalance between CSF formation and absorption, obstruction of CSF pathways, impaired venous absorption, and over secretion of CSF results in excessive accumulation of the fluid in the ventricles, leading to hydrocephalus. Although ventriculo-peritoneal shunt is regarded as the main and definitive therapy for rapidly progressive hydrocephalus, shunts in newborns have a high failure rate and thus there have been a search for alternative non-invasive techniques. Acetazolamide is a carbonic anhy- drase inhibitor, which acts by reducing production of CSF in the choroid plexus. Admini- stration of acetazolamide will decrease the rate of CSF production, preventing progressive ventricular enlargement. We experienced three cases of neonatal hydrocephalus successfully treated by long-term administration of acetazolamide. Brief review and related literatures were also presented.
Absorption ; Acetazolamide* ; Carbon ; Central Nervous System ; Choroid Plexus ; Humans ; Hydrocephalus* ; Infant, Newborn ; Ventriculoperitoneal Shunt

In children, the supracondylar fractures of the humerus are common in elbow region, and often associated with various complications and problems in treatment (ie,Volkmann's ischemic contracture, cubitus valgus or varus deformity, rotational deformity). The results of reduction can be measured by Baumann's angle, carrying angle, trochlea-capitellum angle, and displacement of distal radial styloid process on radiological study. So we have made experiments on the process which various three dimensional displacements reflected into two dimensional Baumann's angle and humerocapitellar angle. And we investigated the process of rotation, through various radiological studies by means of molded models of humerus. The results were as follows:l. In experiments, AP & lateral X-ray studies showed no change in rotation of proximal segment of fracture with fixed distal segment of fracture. 2. On the other hand, AP & lateral X-ray showed significant change, in rotation of proximal fracture segment with distal segment of fracture. 3. Supracondylar rotation angle(S.R.A.)depicted as the ratio of the length of proximal fracture width minus that of the distal fracture width in lateral view, to the length of distal fracture width in AP view minus that of the distal fracture width in lateral view. 4. According to the modified Mitchell result, S.R.A. to the result of treatment was average 7.6 degree in excellent group, 15.2 degree in good group and 29.3 degree in unsatisfactory group.
Child ; Congenital Abnormalities ; Elbow ; Fungi ; Hand ; Humans ; Humerus ; Ischemic Contracture

PURPOSE: To identify the four layers based on intranodular vascular nature visible in multiphase incremental bolus dynamic CT and to determine any differential points according to various factors of liver abscess with this vascular nature or not. MATERIALS AND METHODS: We categonized 29 cases of confirmed liver abscess into three different groups according to presence of four layers visible in early phase(arterial phase) of CT. Three groups were compared in regard to the results of antiamebic antibody test and bacteriologic study and presense of cholangitic abscess and internal septation. RESULTS: We could separate four layers, innermost hypodense central cavitary lesion, hyperdense granular tissue, hypodense abscess wall and outermost hyperdense compensatory hypervascular zone in 18 cases(62%), only two layers, cavity and wall in six cases(21%), and characteristically we could find three layers without innermost cavitary lesion in five cases(17%). But we couldn't find significant correlations between various clinical factors of liver abscess and our vascular groups. CONCLUSION: Our method of CT could represent four layers based on vascularity in 62% of cases. And also could find the unusual inflammatory mass containing three layer which must be differentiated from other malignant solid mass. But we couldn't find differential point between various clinical factor of liver abscess and imaging diagnosis. We think that with the improvement of hardware such as spiral CT, identification of four layers will be earier and will be very helpful in early detection and proper treatment planning of liver abscess.
Abscess* ; Diagnosis ; Liver Abscess* ; Liver* ; Tomography, Spiral Computed

Direct immunofluorescent (DIF) starining was performed on biopsy specimens from four patients with pityraasis lichenoides chronica. Deposits of IgM and C3 were foundin the dermal vessel walls of the lesional skin in two patients with pityriasis lichenoides chronic. Deposition of C3 and cytoid bodies were detected along the dermo-epidermal junction in one patient. This supports the view that deposition of immune complexes may play a part in the pathogenesis of pityriasis lichenoides chronica.
Antigen-Antibody Complex ; Biopsy ; Humans ; Immunoglobulin M ; Pityriasis Lichenoides ; Skin ; Vasculitis*

No abstract available.
Basement Membrane*

We examined the localization of neurofascin (NF) in the sciatic nerve of rat. In the myelinated fibers, neurofascin localizes strongly in the nodal axolemma except the small central cleft and also expresses in the paranodes, and weakly in the Schmidt-Lanterman incisures. In the paranodes, NF localizes around the axolemma and it expresses in the apposing membrane of paranodal loops. Axoplasm, compact myelin and cytoplasm of Schwann cell do not express NF at all. In the Schmidt-Lanterman incisures, NF is expressed weakly along the Schwann cell membrane. We propose that neurofascin may be a plasmalemmal integral protein of Schwann cell in the paranode and plays some important roles for the maintenance of axo-glial junctions at the paranode. It may also have some roles for maintaining the structure of Schmidt-Lanterman incisure and have some relations with proteins localizing in the node.
Animals ; Cell Adhesion Molecules/*analysis/physiology ; Fluorescent Antibody Technique ; Microscopy, Immunoelectron ; Nerve Growth Factors/*analysis/physiology ; Rats ; Rats, Sprague-Dawley ; Sciatic Nerve/*chemistry/ultrastructure

PURPOSE: To evaluate the radiological patterns of vascular invasion in peripheral cholangiocarcinomas. MATERIALS AND METHODS: Hepatic arteriography and portography in 20 cases with cholangiocarcinoma including 12 cases with anglographic CT were retrospectively analized. RESULTS: The arteriography showed no arterioportal shunt, hypertrophy of tumor vessel, or tumor staining extending to central portion of the mass in all cases. However, doughnut shaped peripheral tumor staining was seen until late hepatogram phase in 12 cases and compensatory hyperperfusion around the mass was seen in six cases(eight cases if include arterial CT). Encasement of tumor vessel was seen in 12 cases, and hypertrophy of feeding vessel in nine cases. On portogrphy, the filling defect on segmental portal branch could be demonstrated only in 11 cases. Shape of the portal defect was tapered narrowing in six cases, abrupt narrowing in two cases but intraluminal nodular filling defect was not seen. Remainning three cases were difficult to define the shape. On seven cases of CT during arterial portography, three cases showed mass shaped defect and four showed segmental defect but three of them could demonstrate the partially preserved portal flow in defective portal area. CONCLUSION: Hepatic arteriography in peripheral cholagiocarcinoma showed no evidence of hypertrophy of tumor vessels and tumor stain extending to central portion but peripheral staining on late hepatogram phase and compensatory hyperperfusion could be seen. Portal vein was more commonly involved through perivascular connective tissue invasion rather than by direct extension into the portal lumen.
Angiography* ; Cholangiocarcinoma* ; Connective Tissue ; Hypertrophy ; Portal Vein ; Portography ; Retrospective Studies