No abstract available.
Parenteral Nutrition, Total

Brunn nests are the most common proliferative lesions of the bladder uroepithelium, but exuberant proliferation can mimic bladder tumor on radiologic imaging and cystoscopy. We describe a case of pathologically proven Brunn nests in a 34-year-old man, misdiagnosed as bladder tumor on preoperative imaging studies.
Adult ; Cystoscopy ; Humans ; Urinary Bladder Neoplasms* ; Urinary Bladder*

PURPOSE: evaluate the effectiveness of minimally invasive plate osteosynthesis (MIPO) in unstable fractures of the distal tibia. MATERIALS AND METHODS: From March 2001 to December 2003, 21 cases with unstable fractures of the distal tibia were treated with MIPO technique and followed for at least one year. Eighteen cases were extra-articular and three cases were intra-articular fractures. According to AO classification, six cases were 42-A, four 42-B, one 42-C, seven 43-A, and three 43-C. There was only one case of Gustilo-Anderson type II open fracture. We reviewed the results of fracture healing, axial and rotational deformity, ankle motion, and complications RESULTS: All fractures were healed in an average of 16.1 weeks (range, 11 to 24 weeks). There was only one case of 7-degree posterior angular deformity, but no cases of rotational malalignment. Recovery of ankle motion was satisfactory in all patients within 5-degree loss of motion. Subcutaneous abscess was developed in one case after fracture healing and cured by a drainage with implant removal. CONCLUSION: Although MIPO technique is technically more demanding than the traditional open technique, MIPO technique is an effective method for unstable fractures of the distal tibia because it minimizes incidence of soft-tissue compromise and infection and provides good fracture healing.
Abscess ; Ankle ; Classification ; Congenital Abnormalities ; Drainage ; Fracture Healing ; Fractures, Open ; Humans ; Incidence ; Intra-Articular Fractures ; Tibia*

Acute respiratory distress syndrome (ARDS) is a medical emergency that threatens life. To this day, ARDS is very rarely reported by iodine contrast media, and there is no reported case of ARDS induced by gadolinium contrast media. Here, we present a case with ARDS after the use of gadobutrol (Gadovist) as a magnetic resonance imaging (MRI) contrast medium. A 26 years old female without any medical history, including allergic diseases and without current use of drugs, visited the emergency room for abdominal pain. Her abdominopelvic computed tomography with iodine contrast media showed a right ovarian cyst and possible infective colitis. Eighty-three hours later, she underwent pelvis MRI after injection of 7.5 mL (0.1 mL/kg body weight) of gadobutrol (Gadovist) to evaluate the ovarian cyst. She soon presented respiratory difficulty, edema of the lips, nausea, and vomiting, and we could hear wheezing upon auscultation. She was treated with dexamethasone, epinephrine, and norepinephrine. Her chest X-ray showed bilateral central bat-wing consolidative appearance. Managed with mechanical ventilation, she was extubated 3 days later and discharged without complications.
Adult ; Animals ; Contrast Media/administration & dosage/*adverse effects ; Female ; Gadolinium ; Humans ; Magnetic Resonance Imaging/*methods ; *Organometallic Compounds/adverse effects ; Respiratory Distress Syndrome, Adult/*chemically induced ; Tomography, X-Ray Computed

PURPOSE: To analyze early postoperative complications of calcaneal fractures operated by a lateral extensile approach and to identify risk factors for wound complications. MATERIALS AND METHODS: From July 1990 to February 2003, 116 calcaneal fractures in 104 patients were treated by open reduction and internal fixation through a lateral extensile approach. The patient's records were reviewed for early postoperative complications. Statistical analysis was performed to determine significant relationships between predicted variables and the development of wound complications. RESULTS: Fourteen fractures (12.0%) developed infection. Ten of them were superficial infection and four were deep infection that required surgical treatment. Eight fractures (6.9%) developed skin necrosis. Six of them were marginal skin necrosis and two were flap necrosis that required surgical treatment. Seven fractures (6.0%) developed sural nerve injury, but their symptoms were improved without additional treatment. Open fracture (p=0.003) and prolonged operating time (p=0.049) increased significantly the rate of wound complications. CONCLUSION: The rate of early postoperative complications of calcaneal fractures operated by a lateral extensile approach is high. These complications can be reduced by meticulous treatment of an open wound, reduced operating time within 90 minutes through preoperative planning and skillful technique, and correct incision to avoid damage of the sural nerve.
Fractures, Open ; Humans ; Necrosis ; Postoperative Complications* ; Risk Factors ; Skin ; Sural Nerve ; Wounds and Injuries

Stress fractures occur when the loads applied to a bone exceed the mechanical resistance and fall into two groups. Fatigue fractures, in which abnormal mechanical stress is applied to a normal bone, and insufficiency fractures, in which fracture occurs when stress of normal activity is applied to a bone that has decreased elastic resistance. Femoral shaft insufficiency fractures are reported rarely in patients with postmenopausal osteoporosis. We report a case of repetitive insufficiency fractures of the femoral shaft in 70 year-old female with marked osteoporosis.
Female ; Fractures, Stress ; Humans ; Osteoporosis ; Osteoporosis, Postmenopausal ; Stress, Mechanical

Cryptococcosis is a fungal infection caused by Cryptococcus neoformans which is frequently occurred in the immunosuppressed host. Any organ or tissue may become infected, however, tendon sheath infection is extremely rare. We report a case of primary cryptococcal tenosynovitis after direct skin injury in a patient with rheumatoid arthritis who has been treated with methotrexate and leflunomide.
Arthritis, Rheumatoid ; Cryptococcosis ; Cryptococcus neoformans ; Hand ; Humans ; Immunocompromised Host ; Isoxazoles ; Methotrexate ; Skin ; Tendons ; Tenosynovitis

Trochanteric entry femoral nails have been widely used for fixation of femoral shaft fractures because of easier identification of the entry point. Young patients usually request removal of the nail after healing of the fracture. We experienced a failure and difficulty in removal of the trochanteric entry nail in two adolescent patients. In the patient in which the nail could be removed with difficulty, dense compact bone was formed through the empty interlocking holes and the nail was held just like a latch. This finding was quite similar to the computed tomography findings of the patient in which the nail could not be removed. In order to remove the nail, the newly formed, dense compact bone in the interlocking holes must be broken and detached from the femur itself. We suggest that dense compact bone through the empty interlocking holes might be a clue for difficult removal of the trochanteric entry nail.
Adolescent* ; Femur* ; Humans

Osteochondroma is one of the most common benign tumors. However, intra-articular occurrence is rare, especially in the knee joint; this is a case of osteochondroma forming bony bridge with the patella. The authors experienced a case of intra-articular osteochondroma of the left patella observed in a 58-year-old female, so we reported it with a literature review.
Female ; Humans ; Knee ; Osteochondroma ; Patella

Most discoid menisci are lateral and medial discoid meniscus is very rare. Several articles have reported on bilateral lateral discoid menisci as well as bilateral medial discoid menisci, and a few articles have reported simultaneous medial and lateral discoid menisci in the same knee. Only one case of simultaneous medial and lateral discoid menisci, bilaterally, has been reported. We present another case of a male patient with bilaterally simultaneous medial and lateral discoid menisci, diagnosed with magnetic resonance imaging and arthroscopy. The patient was treated by arthroscopic partial meniscetomy.
Arthroscopy ; Humans ; Knee ; Magnetic Resonance Imaging ; Male