No abstract available.
Calcium* ; Humans ; Infant, Newborn* ; Metabolism*

We present a case of eccrine spiradenoma occurring on the trunk in a 33 year old woman. She developed a pea sized, pinkish tender nodule on the anterior chest 8 years ago. On histologic examination, there were several lobules surrounded by thin connective tissue septa in dermis. The lobules themselves consisted of small dark staining cells and large pale-staining cells, forming solid cords or ducts.
Adult ; Connective Tissue ; Dermis ; Female ; Humans ; Peas ; Thorax

Renal dysplasia results from aberrant metanephric histogenesis caused fundamentally by a defect in inducer tissue or responding tissue. Dysplastic kidneys vary tremendously in gross and microscopic appearance but are characterized by abnormal organization and a mixed population of primitive structures, such as fetal or immature cartilage, dysplastic ducts, immature tubules, and undifferentiated mesenchyme. We report a case of unilateral multicystic renal dysplasia associated with an ipsilateral ectopic ureteral orifice entering a seminal vesicle cyst in a 33-year-old man. He was admitted due to primary infertility which had developed three years ago. The his semen analysis revealed oligospermia. No evidence of a family history of renal dysplasia was reported. Microscopic examination showed that the entire kidney was composed of cysts lined by flattened cells, dysplastic ducts and immature tubules surrounded by collars of spindle cells, primitive mesenchyme, and a few aberrantly formed glomeruli.
Adult ; Cartilage ; Humans ; Infertility ; Kidney ; Male ; Mesoderm ; Multicystic Dysplastic Kidney* ; Oligospermia ; Semen Analysis ; Seminal Vesicles* ; Ureter*

No abstract available.
Adolescent* ; Humans ; Liposarcoma* ; Neck*

The Ilizarov technique has been used successfully in the treatment of nonunion of long bone accompanied by infection, severe bone and soft tissue defects, and deformity. We report the results of treatment of 21 cases of nonunion using the Ilizarov technique. There were 20 males and 1 female with an average age of 34.2 years (range, 8-72 years). The average follow up period was 45 months (range, 12-74months). Infected nonunion(15/21 cases) was the most common cause of nonunion. The treatment methods include simple compression method(4 cases) and internal and external bone transport method(17 cases). Bony union was achieved in 20 cases out of 21 cases. One case is still having difficulty in achieving union. The mean time to union was 7.3 months in femurs and 6.3 months in tibias. The amount of bone defect that developed after the removal of infected bone fragments and soft tissue averaged 3.8cm (range, 2.3-9cm). The healing index, in cases of bone transport, was an average of 45 days per cm (range, 30-62 days per cm). Complications developed in 17 cases out of 21 cases. Pin site infection occurred in 5 cases, premature consolidation in ~1 case, angulation deformity in 2 cases, LOM of the knee in 2 cases, equinus deformity in 2 cases, ankle stiffness in 3 cases, and nonunion in 1 case. The Ilizarov technique is thought to be effective in the treatment of complicated nonunion combined with shortening, deformity, bone defect and infection. However, in order to reduce complications caused by the Ilizarov method, accurate surgical techniques and postoperative care are necessary.
Ankle ; Congenital Abnormalities ; Equinus Deformity ; External Fixators* ; Female ; Femur ; Follow-Up Studies ; Humans ; Ilizarov Technique ; Knee ; Male ; Postoperative Care ; Tibia

PURPOSE: Current evidence indicates that ultrasonography of the breast is an important adjunct to mammography and clinical examination in the diagnosis of palpable breast abnormalities. An assessment of the value of office-based ultrasonography of a palpable breast mass performed by a breast surgeon was the aim of this work. METHODS: A 7.5 MHz linear probe was used to perform office-based ultrasonography in 109 consecutive female patients having a palpable solid breast mass between August 1998 and December 1999. Breast masses diagnosed histologically as fibroadenomas or breast cancer were included in this study. The clinical impression from the physical examination (PE), the result of officed-based ultrasonography done by a surgeon (OUSG), and comprehensive judgement engaging both PE and OUSG (PEUSG) were recorded in each patient's hospital record as benign or malignant at the first visit. The diagnostic values of PE, OUSG, PEUSG, mammography (MMG), and ultrasonography done by a radiologist (USG) were compared. RESULTS: Of 109 masses, a fibroadenoma was diagnosed in 73 patients while a carcinoma was established in 36 patients. The sensitivity, the specificity, the accuracy rate, and the kappa coefficient were 91.7%, 89.0%, 89.9%, and 0.780 for PE; 100%, 90.4%, 93.6%, and 0.862 for OUSG; 97.2%, 97.3%, 97.2%, and 0.938 for PEUSG; 90.4%, 89.4%, 90%, and 0.630 for MMG; and 88.9%, 90.9%, 90% and 0.798 for USG. The diagnostic accuracy of PEUSG was significantly higher than those of PE and MG (p<0.05). CONCLUSION: These data suggest that office-based ultrasonography of the breast performed by a surgeon is a useful adjunct to clinical evaluation of the breast mass and permits timely and cost-effective patient care.
Breast Neoplasms ; Breast* ; Diagnosis* ; Female ; Fibroadenoma ; Hospital Records ; Humans ; Mammography ; Patient Care ; Physical Examination ; Prospective Studies* ; Sensitivity and Specificity ; Ultrasonography*

It is well known that fractures around the knee joint are usually combined with ligament injuries but it is easy to miss the ligament injuries during the treatment of fractures. The invention of the MRI and the development of arthroscopic techniques has made it easy to diagnose and care for ligament injuries. Authors reviewed the patients who had fractures around the knee joint to evaluate the frequencies, types, treatments and the results of combined ligaments injuries. There were 57 cases with the fracture of the proximal tibia and fibula which could be follwed up at least one year: from January 1992 to June 1995. There were 19 cases (33%) which had combined ligament injuries. The ligament injuries were diagnosed by stress X-ray & MRI evaluation and confirmed by arthroscopic examination. Single lateral rim avulsion fracture of proximal tibia was the most common type of fractures (7 cases, 37%). There were 11 cases (57%) of combined injuries of anterior cruciate ligament and medial collateral ligament. It was the most common combined ligament injury. Except for one, eleven cases that were combined with lateral rim avulsion of proximal tibia had anterior cruciate ligament injury. There were ten cases (53%) of fibula head and neck fractures which were combined with ligament injuries. The total number of the injured ligament was 35 and the common rupture sites of the injured ligaments was the attachment site of femur (13 cases) and tibia (16 cases). There were seven meniscal injury cases (37%). The interval from injury to operation averaged 14.1 days because many cases were acute injuries. Primary repairs for ruptured ligament were done in 31 cases (88%) because of their attachment site injuries. There were no instabilities except one case which was treated with posterior cruciate ligament reconstruction using semitendinosus ligament. It had a grade I posterior instability at the last follow-up. Early diagnosis and proper treatment on the ruptured ligaments and the torn meniscus combined with proximal tibia and fibular fractures seem to be important for a good prognosis.
Anterior Cruciate Ligament ; Collateral Ligaments ; Early Diagnosis ; Femur ; Fibula* ; Follow-Up Studies ; Head ; Humans ; Inventions ; Knee ; Knee Joint ; Ligaments* ; Magnetic Resonance Imaging ; Neck ; Posterior Cruciate Ligament ; Prognosis ; Rupture ; Tibia*

No abstract available.
Peutz-Jeghers Syndrome*

PURPOSE: To evaluate the efficacy of dynamic colpocystodefecography in patients with a pelvic organ prolapse. MATERIALS AND METHODS: A total of 63 patients, with or without stress urinary incontinence and pelvic organ prolapse, who visited our hospital between April 2002 and July 2003, were studied. All patients were available for physical examination and dynamic colpocystodefecography. The patient was seated on a radiolucent commode, which was upright on the end of a vertically oriented x-ray table. Deliberate efforts were made to ensure privacy. Fluoroscopic images were taken during resting, squeezing, Valsalva effort, voiding and defecation. RESULTS: On physical examination, cystocele, rectocele and rectal intussusception were revealed in 26 (36%), 20 (31%) and 7 cases (11%), respectively. On dynamic colpocystodefecography, cystocele, rectocele and rectal intussusception were revealed in 44 (69%), 32 (50%) and 15 cases (24%), respectively. Compared with the physical examination, 18 cases of cystocele, 12 of rectocele and 8 of rectal intussusception were newly found through dynamic colpocystodefecography. Enterocele and sigmoidocele were not found in the physical examination, but only found through dynamic colpocystodefecography in 4 and 5 cases, respectively. The degree of prolapse was more severe during defecation than voiding. CONCLUSIONS: Not all the pelvic organ prolapses were detected on physical examination. Radiological evaluation is necessary for a more accurate detection of a pelvic organ prolapse. Dynamic colpocystodefecography has the advantages of it's ability to be performed for physiological defecation and voiding status, as well as imaging of dynamic pelvic organ structures.
Cystocele ; Defecation ; Defecography ; Hernia ; Humans ; Intussusception ; Pelvic Organ Prolapse* ; Physical Examination ; Privacy ; Prolapse ; Rectocele ; Urinary Bladder ; Urinary Incontinence ; Vagina

No abstract available.
Child* ; Glomerulonephritis* ; Humans