Rosai-Dorfman disease (RDD) is a rare type of benign histiocytosis characterized histologically by intracellular engulfment of lymphocytes. Extranodal RDD may occur as a part of generalized process involving lymph nodes or may involve extranodal sites independent of the lymph node status. We have experienced a case of extranodal Rosai-Dorfman disease of the nose as an initial lesion prior to nodal involvement. The patient was a 20-year-old woman who complained of nasal obstruction for 4 years, remotely, and left submandibular mass for 3 months, recently. Histologically, the lesion taken from nasal cavity, submandibular gland and left upper jugular lymph node all showed an heavy infiltrate consisted of plasma cells, lymphocytes and sheets of macrophages with abundant pale cytoplasm, which replaced organ architecture. The associated focal fibrosis made it difficult to differentiate from inflammatory pseudotumor. Some macrophages demonstrated phagocytosis of lymphocytes, plasma cells and occasionally neutrophils. The macrophages were strongly positive for S-100 protein.
Cytoplasm ; Female ; Fibrosis ; Granuloma, Plasma Cell ; Histiocytosis ; Histiocytosis, Sinus* ; Humans ; Lymph Nodes ; Lymphocytes ; Macrophages ; Nasal Cavity ; Nasal Obstruction ; Neutrophils ; Nose* ; Phagocytosis ; Plasma Cells ; S100 Proteins ; Salivary Glands* ; Submandibular Gland ; Young Adult

Peripheral T-cell lymphoma is the generic group given to a family of tumors composed of neoplastic lymphocytes with phenotypic features of peripheral T-cells. Certain peripheral T-cell lymphomas develop a hemophagocytic syndrome that mimics malignant histiocytosis, both clinically and pathologically. We experienced a case of nasal T-cell lymphoma, histologically mimicking malignant histiocytosis in a 40-year-old male. The chief complaints were nasal obstruction and intermittent mild fever. Mild anemia, elevated SGOT and SGPT, polyclonal gammophthy, and moderate hepatomegaly were present. Two weeks later was present an enlarged cervical lymph node. The biopsied nasal mass showed angiocentric and angiodestructive peripheral T-cell lymphoma withextensive necrosis and marked erythrophagocytosis by non-neoplastic histiocytes. Subsequently, cervical lymph node was biopsied, which showed peripheral T-cell ltmphoma with extensive necrosis and erythrophagocytosis as well. The atypical lymphoid cells revealed pan-T(+), but CD4(-) and CD8(-), whereas the reactive histiocytes showed lysozyme(+), immunohistochemistry.

No abstract available.
Epidural Abscess*

The spinal injuries were classified into bursting fracture, fracture-dislocation, seat-belt injury, compression fracture according to the three column theory by Denis. The bursting fracture and fracture-dislocation required the most careful planning. So, myelography, computerized tomography enabled us to diagnose the spinal fracture including retropulsed bony fragment into the spinal canal. There was much controversy as to appropriate treatment af unstable thoraco-lumbar fractures. The frequent surgical treatment of thoraco-lumbar spinal fractures was still posterior spinal instrumentation including Harrington rod system. Since 1964, the use of anterior spinal instrumentation had been started by Dwyer, Dunn, Kostrik, Slot, and Zielke used anterior spinal instrumentation in unstable thoraco-lumbar spinal fractures, but not popular. This study suggested the experience to accomplish the decompression of the neural elements and stabilization of the spine by using Kandea device in unstable thoraco-lumbar spinal fractures. 12 patients treated with this Kaneda device in unstable thoraco-lumbar spinal fractures were analyzed from Dec. 1988 to May, 1989 at the Department of Orthopaedic Surgery, Ewha Womans University Hospital. We obtained the following conclusions. The results were as follows. 1. The common injury mechanism was falling down in 5 cases, the frequent injury site was 1st lumbar vertebra. 2. According to Denis classification, the bursting fractures were in 8 cases(68% ), the fracture-dislocations were in 4 cases(33%). 3. The average preoperative kyphotic angulation was 24.5 degrees(range 8 to 45) and postoperative angulation was 5 degrees(range 2 to 15), the correction rate was 79.6% and correction degree was average 19.5 degrees. 4. The advantages were the fixation of one level above and below the injury site, sufficient neural decompression, firm spinal stabilization, early mobilization with a brace and elimination of the 2nd posterior procedure. 5. The fixation of vertebral plate was difficult due to the invariable size of vertebral plates, especially, in upper thoracic spinal fracture and children's fracture.
Accidental Falls ; Braces ; Classification ; Decompression ; Early Ambulation ; Female ; Fractures, Compression ; Humans ; Myelography ; Spinal Canal ; Spinal Fractures ; Spinal Injuries ; Spine

Bone tumor in the trochanteric area is not infrequent and it is important to differentiate the tumors in this area for diagnosis, early settings of therapeutic plans and prognostic previsions. Twenty-one cases of benign bone tumors in the trochanteric area treated at Dept. of Orthopedi Surgery, College of Medicine, Ewha Womans University Hospital, from January 1975 to December 1983 were analysed and following results were obtained. l. of 21 cases, 10 cases were fibrous dysplasia, 6 cases were simple bone cyst, 3 were giant ce tumor and 2 were aneurysmal bone cyst. 2. Pathologic fractures were accompanied in 6 cases; 3 of fibrous dysplasia, 2 of simple bone cy: and 1 of aneurysmal bone cyst. 3. After treatment with curettage, bone graft and instrumentation, 3 cases recurred; 2 cases of fibrous dysplasia and 1 of simple bone cyst. 4. As prognostic factors, completeness of curettage, amount and source of bone graft were considered to be important.
Aneurysm ; Bone Cysts ; Clinical Study ; Curettage ; Early Diagnosis ; Female ; Femur ; Fractures, Spontaneous ; Humans ; Transplants

Femoral shaft fractures are usually accompanied with extensive soft tissue injury due to high energy force and are difficult to manage for functional stress with weight bearing. According to Boyd(1965), femoral shaft is the first of non-union among the long bone shafts. And because of inadequate internal fixation, poor immobilization and infection, non-union of femoral shaft is still of interest to all the orthopaedic surgeons. During past 10 years, 19 cases of non-union of the femoral shaft were treated at dept. of Orthopaedic Surgery, Ewha Womans University hospital and following results were obtained. l. Of 19 cases, male between 20-40th age group was predominent. Prevalent type and site was mid. 1/3 comminuted fractures(p > 0.05). 2. Initial treatment was 10 cases of intramedullary nailing; 8 of plate fixation; 1 of screw fixation. Bone graft was added to 10 cases. 3. The probable causes of non-union were complex; 11 of inadequate interal fixation, 4 of poor external immobilization and 4 of infection. 4. 4 cases of infection were managed with control of infection and fixation. And 11 cases were fixed with plate and the other 4, with intramedullary nailing. All were supplemented with autogenous bone graft. 5. Postoperative immobilization was done with 15 cases of hip spica cast and 4 of long leg cast for average 9.3 weeks. 6. All were united at average 8.9 months. Limitation of motion of knee was remained in 3 cases in spite of physiotherapy. Severe osteoporosis was noted in 3 cases and leg length shortening with limping was found in 1 case.
Adult ; Clinical Study ; Female ; Femur ; Fracture Fixation, Intramedullary ; Hip ; Humans ; Immobilization ; Knee ; Leg ; Male ; Osteoporosis ; Soft Tissue Injuries ; Surgeons ; Transplants ; Weight-Bearing

In 1943, Alberto Inclan reported tumoral calcinosis in 3 cases at major joints. This condition usually showed large, painless calcified mass in major juxtaarticular sites, and evidence of familial or racial predisposition in blacks but abnormal values of serum calcium and phosphorus, association with renal disease, metabolic disorder and collagen disease are seldom seen. Tumoral calcinosis in large joints such as hip, knee, elbow and shoulder was reported several cases. Tumoral calcinosis in hand and foot is very rare and not reported yet in this country. Recently, authors experienced a case of tumoral calcinosis in both hands and right foot and cured without recurrence in 1 year follow up.
African Continental Ancestry Group ; Calcinosis ; Calcium ; Collagen Diseases ; Elbow ; Follow-Up Studies ; Foot ; Hand ; Hip ; Humans ; Joints ; Knee ; Metabolic Diseases ; Phosphorus ; Recurrence ; Shoulder

Spondylolisthesis, frequently encountered problems with increasing incidence, has been recognizid as an important clinical entity in orthopaedic field. Several methods were applicated as operative treatment of spondylolisthesis; posterior fusion or H-graft, posterolateral fusion, anterior fusion, fixation with internal devices and etc. During the past 12 years from March 1972 to February 1984, 34 patients among the 42 patients were treated surgically at Department of Orthopaedic Surgery of Ewha Womans University Hospital and following results were obtained. 1. The average age was 45.2 years(19 ~ 64 years) and female was predominent(64.7%). Isthmic type was 17 patients(50.0%), degenerative type was 13 patients(38.2%) and dysplastic type was 4 patients(11.8%). Below 40 year old, dysplastic and isthmic type were predominent and degenerative type was more common in the age group above forties. 2. The most prevalent site was L5-Sl; 21 cases(61.8%) and L4-5; 13 cases(38.2%) in orders. In isthmic type L5-Sl was 13 cases and in degenerative type, L4-L5 was 9 cases. By Meyerding classification, grade I was most common(26 patients, 76.5%). 3. The clinical pictures were low back pain only and little improvement with conservative treatment(type I: 9 patients), low back pain with sciatica(type II: 13), type II plus neurologic signs such as motor weakness, sensory change or change of D.T.R(type III, 10) and little low back pain with mainly sciatica(type IV, 2). 4. Of 34 patients, anterior interbody fusion were done in 10 patients ; posterior and posterolateral fusion with decompression were done in 22 patients. Only laminectomy were done in 2 patients(type IV). 5. Fusion rate was observed in 21 patients(95.5%) among 22 patients with posterior or posterolateral fusion and 8(80%) among the 10 patients with anterior fusion. Postopertive functional results by Gill's criteria were excellent or good in 31 patients(91%). 6. There were no difference in fusion rate and functional results in operative methods.
Classification ; Clinical Study ; Decompression ; Female ; Humans ; Incidence ; Laminectomy ; Low Back Pain ; Neurologic Manifestations ; Spondylolisthesis

Fractures of both forearm bones present specific therapeutic preoblems encountered infrequently in the fractures of other shafts of long bones. Although some of these fractures can be treated conservatively, majority of fractures are treated by open reduction and internal fixation for accurate anatomic reduction and rigid fixation. From January 1979 to December 1986, seventy two cases of both forearm bone fractures had been treated by four different methods at the Department of Orthopaedic Surgery, College of Medicine, Ewha Womans University and results were obtained as follows : 1. The most common fractures site was middle third of radius and ulna. 2. Comminuted fx was most common in radius and oblique fracture was most frequent. 3. Eleven cases were treated conservatively and 61 cases were treated by open reduction. Among them, 2 cases were fixed with intramedullary nailing, 36 cases by plating and 23 cases by combined method. 4. The time required for bony union was shorter in group of open reduction and plating than in groups of the other treatment. 5. The functional result was satisfactory in 53 cases(74%) and was best in group of open reduction and plating. 6. Among 5 cases of nonunion, 3 cases were developed in open fractures.
Adult ; Female ; Forearm ; Fracture Fixation, Intramedullary ; Fractures, Bone ; Fractures, Open ; Humans ; Methods ; Radius ; Ulna

While benign tumors of tendons and aponeuroses are observed commonly and have been defined adequately, malignant tumors originating from these tissues are rare. Among those reported most had been classified as synovial sarcoma or fibrosarcoma until Ezinger in 1965 described a new type that he called “clear cell sarcoma” of tendon and aponeurosis. Recently, Ultrastructural and histochemical analysis has revealed that the tumor cells contain melanin in the form of melanosomes in varying stages of development and currently, the neoplasm is considered a primary malignant melanoma of the soft tissue. A csse of clear cell sarcoma of flexor tendon in the wrist is reported, with an emphasis on its electron microscopic description.
Fibrosarcoma ; Melanins ; Melanoma ; Melanosomes ; Sarcoma, Clear Cell ; Sarcoma, Synovial ; Tendons ; Wrist