In our review of 36 hematogenous osteomyelitis nine cases were subacute form. Distal tibia was the most commonly involved location(four of nine patients). According to the modified Robert's classification cross-physeal lesions were the most common type(four of nine patients). In most of the cases the clinical findings and laboratory data were not much helpful for current diagnosis. Four patients had radiographic findings similar to those of tumors such as Ewing' s sarcoma, osteoid osteoma or bone cyst. Magnetic resonance imaging was useful in the identification of early lesions. In three patients Staphylococcus aureus was isolated by bacterial culture of biopsy specimen. In the remaining six patients diagnosis was made by histological evaluation. All patients except one were treated by curettage and antibiotics. In the other patient the disease showed a tendency of spontaneous healing without operative intervention and antibiotics. Cross-physeal lesion seemed to be a typical finding of the subacute osteomyelitis.
Anti-Bacterial Agents ; Biopsy ; Bone Cysts ; Child ; Classification ; Curettage ; Diagnosis ; Humans ; Magnetic Resonance Imaging ; Osteoma, Osteoid ; Osteomyelitis ; Retrospective Studies ; Sarcoma ; Staphylococcus aureus ; Tibia

Arthroscopically assisted anterior cruciate ligament(ACL) reconsturction provide a technique with less morbidity, less pin, less sacr, lower ris k of sepsis. The magnification offered by arthroscopic visualization also provide a clearer view, more precise location of anatomical landmarks, and the ability to place the graft in the exact anatomic sites. However, in order to accomplish all these goals, the surgeon must possess a high level of psychomotor skills, which take time and practice to develop. Wile this learning curve is being completed, there are occasion when complications will occur, and, realistically these may be difficult to avoid. The purpose of this study is to evaluate author's cases in which complication occurred during the endoscopic one-incision ACL reconstruction using the patellar tendon and to offer some tips on how to avoid them and how to salvage the situation if they do occur. We reviewed 22 complications (11 patients) out of 40 ACL reconstructions performed between May 1994 and December 1995. The complications were divergence(6), graft-tunnel mismatch(5), too anterior tibial tunnel(3), too anterior femoral tunnel(2), too posterior femoral tunnel(2), rotation of screw around the graft(2), guide pin breakage(1), bone plug retraction into the joint(1). It is suggested that arthroscopist should constantly try to avoid the intraoperative complications of arthroscopically assisted ACL reconstruction and follow the precautions and preventive measures recommended.
Intraoperative Complications ; Knee ; Learning Curve ; Patellar Ligament ; Sepsis ; Transplants

The pathophysiology of pediatric encopresis has been incomprehensible. The current study was designed to assess its clinical and physiologic findings. Moreover, outcome of treatment was evaluated. METHODS: The clinical and functional findings of 18 patients (13 boys, 5 girls) were analyzed, retrospectively. Physiologic studies for cooperative child included anal manometry (n=12), cinedefecography (n=3), and PNTML (pudendal nerve terminal motor latency, n=1). For exclusion of the organic cause, barium contrast study was carried out in all case. Patients were categorized by leading symptom as constipation or incontinence. Physiologic findings and outcome of treatment were analyzed based on the categorized groups. Biofeedback therapy by using newly-developed anal sphincter control system (KONTINENCE CLINICAL(TM)) in my institute, was underwent a mean 4.1 (range, 2~12) sessions. The outcome was analyzed in the period of 5.4 (range, 1~33) months follow-up. RESULTS: Patients were categorized as having constipation (group I, n=12) or incontinence (group II, n=6) group. In the manometric parameters, there were no statistical differences between the values of the mean resting pressure (RP), the maximum RP, and the maximum voluntary contraction between group I and II. In the cinedefecography, 3 of group I patients revealed as having the pelvic floor dyssynergia. The findings of PNTML were not specific in group II (n=1). Regarding to the therapeutic outcome, 8 of 10 patients were cured or improved. CONCLUSIONS: There were no differences in the resting and squeeze profiles of manometric parameters between two groups. However, pelvic floor dyssynergia was identified in the cinedefecography of constipated group. Conventional and biofeedback treatment for encopretic children provides acceptable outcome.
Anal Canal ; Ataxia ; Barium ; Biofeedback, Psychology ; Child ; Constipation ; Defecography ; Encopresis* ; Follow-Up Studies ; Humans ; Manometry ; Pelvic Floor ; Retrospective Studies

The types of the synovial plicae were classified according to the classification of Kim and Choe(1997). The purpose of this study was to evaluate the diagnostic ability of MRI for synovial plicae. We retrospectively reviewed the MR findings of the knee in 95 cases of 91 patients. In all 95 cases, findings of arthroscopy and MR images were available. MRI was performed with a 1.5 Tesla Magnetom(Siemens) using a round surface coil. Pulse sequence were Tl weighted image(TR 650ms /TE 20ms) and T2 weighted image(TR 2000ms/TE 70ms). MR images could not show the infrapatella plicae and lateral plicae clearly, but some suprapatellar plicae were shown in T2 weighted MR images (37.5% of hole type, 80% of complete type, 26% of medial type). In 20(22%) of the 90 cases with medial patella plicae proved by arthroscopy, a low intensity band was shown above the medial condyle of the femur on T2 weighted MR images. These 20 cases included 3 of fenestra type, 9 of wide shelf type and 8 of medial shelf type. The low intensity band seen on T2-weighted MR images and its anatomical relation to the medial femoral condyle are helpful in diagnosing the presence of medial shelf type and wide shelf type of medial plicae.
Arthroscopy* ; Classification ; Femur ; Humans ; Knee* ; Magnetic Resonance Imaging* ; Patella ; Retrospective Studies

A 26-year-old Korean man had an erythematous scaly plaque on his right thigh for fifteen years. He was diagnosed with chronic eczema and treated with topical steroid, but no clinical improvement was obtained for 15 years. Laboratory studies including complete blood cell count, urinalysis, liver and renal function test, and peripheral blood smear were normal. A biopsy specimen showed hyperkeratosis, acanthosis, and mononuclear cellular infiltration in the epidermis. These cells had a perinuclear halo and showed a Pautrier's microabscess like configuration. In the dermis, there was a band like infiltration of inflammatory cells. Infiltrates of the epidermis were negative for leukocyte common antigen(CD45) and positive for Pan T cell(CD45RO). He was treated with topical PUVA twice a week for twelve weeks. Clinical and pathological improvements were obtained. We propose PUVA may be a useful therapeutic modality to treat Woringer Kolopp disease.
Adult ; Biopsy ; Blood Cell Count ; Dermis ; Eczema ; Epidermis ; Humans ; Leukocytes ; Liver ; Pagetoid Reticulosis* ; Thigh ; Urinalysis

No abstract available.
Arteritis* ; Lupus Erythematosus, Systemic* ; Nephritis*

PURPOSE: Magnetization transfer imaging(MTI) is a new imaging contrast technique. Our MT pulse sequence is designed as fixed time interval between echo and MT pulse. This study was peformed to evaluate the influence of variations in TR/TE on MTR in T1 weighted image of normal brain tissue on this kind of MT pulse sequence. MATERIALS AND METHODS: Seven healthy volunteers in twenties of age as the objectives, MRI was taken under various TR/TE(TR/TE ;700/14, 650/14, 750/14, 700/20 and 1500/20 msec). MTR was calculated from signal intensities measured at the same point in both pre and post MT images and statisticslly analyzed. The MR imager used in this study was 1.0T Magnetom 42SP(Siemens, Erlangen, Germany) and the parameters of additional MT pulse sequence were offset 1000Hz and bandwidth 250Hz, and posteriorly located to echo with 7.7 msec fixed interval. Offset of this MT pulse was variable. RESULT: In white matter of brain tissue from a normal person, MTR was 34-39%(average 37%) for TR and TE of 700/14 in T1WI and 33-36%(average 35%) for TR/TE of 650/14, and 34-38%(average 35%) for TR/TE of 750/14 which showed no statistical difference. However, in case of 1500/20 of TR/TE, MTR was 26-28%(average 26%) which is statistically significant. With TR/TE of 700/14 as the standrd value, the MTR of gray and white matter were 37% and 29% respectively, showing a definite difference of statistical means. Signal from CSF in ventricles is rarely influenced by MT pulse. CONCLUSION: Conclusively, a subtle variation in TR/TE in T1WI has little influence on MTR but wide range of variation in TR/TE as in proton density image induces significant difference in MTR on this kind of MT pulse sequence. Therefore, the exchangeable usage of MTR data would be possible in narrow range of TR/TE change but difficult in wide range of variation.
Brain* ; Healthy Volunteers ; Humans ; Magnetic Resonance Imaging ; Protons ; Reference Values*

Although a number of remedies like corticosteroids, retinoids, griseofulvin, PUVA, cyclosporine, antibiotics, dapsone, cyclophosphamide, surgery, methotrexate, radiation therapy, antimalarial drugs, psychotharapy and psychiatric medications have been used to treat lichen planus, there were no specific methods until now. We report herein an interesting case of lichen planus in which complete healing was achieved by griseofulvin administration. The patient was a 54-year-old male who for 3 months had variouly sized and shaped, flat-topped, scaly, violaceous papules and plaques on the whole of his body. We confirmed the patients disease as lichen planus by a histopathologic examination of a skin biopsy specimen and gave him 500mg ultramicronized griseofulvin daily in divided dosages. After 12 weeks of the medication nearly all of the skin lesions were regressed, and by 14 weeks all skin lesions had disappeared leaving hyperpigmentation. Up to now, l9 months after discontinuation of the medication, no recurrence of the disease has been noted.
Adrenal Cortex Hormones ; Anti-Bacterial Agents ; Antimalarials ; Biopsy ; Cyclophosphamide ; Cyclosporine ; Dapsone ; Griseofulvin* ; Humans ; Hyperpigmentation ; Lichen Planus* ; Lichens* ; Male ; Methotrexate ; Middle Aged ; Recurrence ; Retinoids ; Skin

A 5-month-old male infantshowed greasy sealy papules on the scalp, dirty scaly papules on the trunk and scaly petechial papules on both the palms and soles since birth. When admitted to the hospital, the patient exhibited lymphadenopathy, hepatomegaly, abdominal distension, mild fever and skin eruption. The biopsy specimens from the skin and lymph node showed an infiltrate composed almost entirely of histiocytic cells with irregularly shaped nuclei and abundant, well demarcated cytoplasm. The histiocytic cells of the infiltrate were proved as Langerhans cells by electron microscopic examination and S-100 protein study. He was treated with methotrexate 30mg/m twice a week and prednisolone 40mg/m daily. Initially skin lesions and general condition were improved, but the patient expired. due to septicemia after 3 months.
Biopsy ; Cytoplasm ; Fever ; Hepatomegaly ; Humans ; Infant ; Langerhans Cells ; Lymph Nodes ; Lymphatic Diseases ; Male ; Methotrexate ; Parturition ; Prednisolone ; S100 Proteins ; Scalp ; Sepsis ; Skin

The solid and hematologic cancer are occasionally accompanied by peripheral blood eosinophilia and suggest tumor necrosis or wide dissemination, but the mechanisms underlying this curious relationship remain obscure. The association of this eosinophilic leukemoid reaction with carcinoma seems to occur must frequently with bronchogenic carcinoma. Several mechanisms for this association were considered: eosinophil chemotactic factor, eosinophil mediated by T-lymphocyte, and eosinopoietic hormone. We are here reporting a case of bronchoalveolar cell carcinoma of lung associated with peripheral eosinophilia in a 60-year-old male patient.
Carcinoma, Bronchogenic ; Eosinophilia* ; Eosinophils ; Humans ; Leukemoid Reaction ; Lung* ; Male ; Middle Aged ; Necrosis ; T-Lymphocytes