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

Sarcoidosis is a rare d:sease in Korea and its association with erythema nodosurn is even rarer. Recently we saw a patient of bihilar adenopathy, who had arthralgia and erythematous nodules of both lower legs. A skin biopsy obtained from the erythematous nodule of the lower leg showed septal panniculitis, consitent with erythema nodosum, and a biopsy from the mediastinal lymph node revealed a pathology consistent with sarcoidosis. This is the first case of Lofgrens syndrome confirmed by histology ir, Korea.
Arthralgia ; Biopsy ; Erythema ; Erythema Nodosum ; Humans ; Korea ; Leg ; Lymph Nodes ; Panniculitis ; Pathology ; Sarcoidosis ; Skin

No abstract available.
Alopecia* ; Tissue Expansion Devices*

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

No abstract available.
Female ; Pregnancy ; Pregnancy, Ectopic*

We present a case of onychogryphosis of both great toe nails associated with onychomycosis of all toe nails occurring in a 90-year-old female patient. She also had senile dementia. Affected nail plates were thickened, increased in length, and curved like the horn of a ram. The nail plates were removed surgically form the nail bed. Direct microscopic examination revealed many hyphae with potassium hydroxide. Trichophyton rnbrum was isolated from the culture in Sabouraud glucose agar media. On histopathologic examination, we found many hyphae in the nail plate. We suggest an onychomycosis as one of the causes of onychogryphosis.
Agar ; Aged, 80 and over ; Alzheimer Disease ; Animals ; Female ; Glucose ; Horns ; Humans ; Hyphae ; Onychomycosis* ; Potassium ; Toes ; Trichophyton

The latissimus dorsi muscle or musculocutaneous flap is one of the most useful flaps in reconstructive surgery. This flap has many advantages, such as its reliable anatomy, long pedicle with large caliber vessels, minimal functional deficit of the donor site, and low incidence of donor site complications. However, the bulkiness of the flap has been considered a disadvantage, so various modifications of technique have been devised. The cutaneous portion of the flap can be safely elevated based on the cutaneous perforating branch of the thoracodorsal vessel. From March 1997 to February 1998, 10 patients underwent reconstructive procedures with thoracodorsal perforator-based free flaps. The composition of the flaps varied in accordance with the nature of the defect. The variances in the flaps were as follows; 3 were cutaneous, 6 musculocutaneous, and 1 osteomusculocutaneous including the rib. All flaps survived with good contour. We concluded that this thin and reliable flap was useful for reconstruction of various defects, and that the composition of the flap, such as subcutaneous, muscle and bone, gave it considerable flexibility as needed.
Free Tissue Flaps* ; Humans ; Incidence ; Myocutaneous Flap ; Pliability ; Ribs ; Superficial Back Muscles ; Tissue Donors

No abstract available.
Hydronephrosis* ; Teratoma*

For the reconstruction of various tissue defects, free tissue transfer has been a very popular method in recent years. A large thin flap is required for aesthetic and functional resurfacing of the extremity defects. As a result, anterolateral thigh free flap has been thought to be useful in reconstructing soft tissue defects requiring thin flap coverage of extremities. The anterolateral thigh flap is a septocutaneous flap based on the septocutaneous or musculocutaneous perforators of the lateral femoral circumflex system. It supplies a large area of skin on the anterolateral aspect of the thigh. The advantages of this flap are safe elevation, a long vascular pedicle, and large caliber vessel. The donor scar is inconspicuous and it could also be used in a sensated flap. From September 1996 to December 1997, 16 cases of soft tissue defect on extremities were resurfaced with anterolateral thigh free flap and the outcomes were satisfactory. This flap is considered useful in one-stage reconstruction of large soft tissue defects of extremities.
Cicatrix ; Equipment and Supplies ; Extremities* ; Free Tissue Flaps* ; Humans ; Skin ; Thigh* ; Tissue Donors

There is increasing evidence that inactivation of tumor-suppressor genes can promote tumor growth. Retinoblastoma protein (pRb) is the product of the retinoblastoma gene located on chromosome 13q14. pRb negatively regulates cell growth when functioning normally. Mutational inactivation of the Rb gene has been observed in retinoblastomas, osteosarcomas and soft tissue sarcomas. Recently, several other human cancers have also been shown to carry abnormalities of the Rb gene. The potential role of the Rb gene in cutaneous squamous cell carcinomas (SCCs) and basal cell caicinomas (BCCs), has not been determined and was the focus of this study. Immunohistochemical expression of pRb in 16 cutaneous SCCs and 17 BCCs was examined. The expression of PCNA was studied in parallel to assess the cellular proliferation rate in these lesions. The pRb and PCNA immunoreactivity were localized to the nuclei of tumor cells. A few pRb and PCNA positive cells were seen in normal squamous epithelium, sebaceous glands, sweat glands and hair follicles. The loss of expression of pRb was seen in 3 of 16 SCCs(18.8%) and 6 of 17 BCCs (35.3%). PCNA immunoreactivity was slightly high in pRb-negative or lower-positive cases. PCNA immunoreactivity was similar to that produced by pRb in some cases. These results suggest that mutational inactivation of the Rb gene may be related to the carcinogenesis of cutaneous SCC and BCC, though the frequency is relatively low.
Carcinogenesis ; Carcinoma, Basal Cell* ; Carcinoma, Squamous Cell* ; Cell Proliferation ; Epithelium ; Genes, Retinoblastoma ; Hair Follicle ; Humans ; Osteosarcoma ; Proliferating Cell Nuclear Antigen ; Retinoblastoma Protein* ; Retinoblastoma* ; Sarcoma ; Sebaceous Glands ; Sweat Glands