Purpose: To evaluate and introduce the technique of C-arm guided aspiration and an injection of a mixture of corticosteroid and local anesthesia for the treatment of calcific tendinitis of the rectus femoris around the hip joint. Materials and Methods: Between March 2003 and May 2005, C-arm guided aspiration and an injection of a mixture of corticosteroid and local anesthesia were performed on 5 patients and a local excision were performed in 1 patient for the treatment of calcific tendinitis of the rectus femoris. The minimum follow-up period was 6 months. The radiology evaluation revealed the presence and size of the calcification. The clinical evaluation involved checking the level of pain relief, range of motion, recurrence, complications. Results: The hip pain improved immediately after treatment. There were no recurrences or complications. Conclusion: The combined treatment of C-arm guided aspiration and an injection of a mixture of corticosteroid and local anesthesia is an effective method for treating calcific tendinitis of the rectus femoris, which can induce rapid symptom relief without any surgical morbidity.
Anesthesia, Local ; Follow-Up Studies ; Hip Joint* ; Hip* ; Humans ; Quadriceps Muscle* ; Range of Motion, Articular ; Recurrence ; Tendinopathy*

We describe a 8-year-old girl with erythrokeratodermia varibilis (EKV). This diagnosis was supported by erythematous, configurate patches over the entire body. Their size, shape and location varyed with enviromental factors and emotional state. In addition, well defined brownish, hyperkeratotic plaques were scattered over the trunk and extremities. Also, this patient had alopecia universalis, which is not typical of EKV. Etretinate therapy resulted in an almost complete clinical clearing of the plaques; however, her alopecia universalis and erythematous lesions were not affected.
Acitretin ; Alopecia* ; Child ; Diagnosis ; Erythrokeratodermia Variabilis* ; Etretinate ; Extremities ; Female ; Humans

We report herein a. case of angio-Behqets syndrome, arterial occlusion type in a 31 year-old male. He had a history of scrotal ulceration, frequent oral ulceration and ocular pain with decreased visual acuity. About 8 months ago, moderately dull pain developed on the volar aspect of left index finger. Subsequently, a bean sized bluish patch developed on the previous painful area and on the ipsilateral thumb tip. Subungual splinter hemorrhages developed on the distal portions of left thumb and index finger nails at the same time. The result of saline puncture test showed the positive reaction in both intradermal and subeutaneous injections. The hrachial angiography showed an obliteration of digital artery at the second proxirnal phalanx of ulnar side.
Adult ; Angiography ; Arteries ; Behcet Syndrome* ; Fingers ; Hemorrhage ; Humans ; Male ; Oral Ulcer ; Punctures ; Thumb ; Ulcer ; Visual Acuity

A retrospective, multivariate statistical analysis of 394 patients who underwent cleft palate repair was performed to document the incidence of postoperative oronasal fistula formation, and to assess possible contributing factors. Fistulas of the secondary palate were included, but nasal-alveolar fistulas and intentionally unrepaired anterior palatal fistulas were excluded. Postoperative oronasal fistulas occurred in 25 of the 394 patients(6.35%). The mean age at repair was 16.4 months, and mean follow-up period was 2.5 years. Several variables that are included sex, age, extent of clefting(as estimated by the Veau classification), type of repair, and experience level of the operating surgeon were analyzed by means of the log-rank test to determine their significance in postoperative fistula formation. Sex (p=0.077), age(p=0.538), and experience level of the operating surgeon(p=0.094) did not significantly affect the rate of fistula formation. However, extent of clefting(p=0.005) and type of repair(p=0.001) are the strongest predictor of the occurrence of a cleft palate fistula.
Cleft Palate ; Fistula* ; Follow-Up Studies ; Humans ; Incidence ; Intention ; Palate ; Retrospective Studies

No abstract available.
Anesthetics*

The perichondrium has neochondrogenic potential. Many authors have published their study for the cartilage regeneration from perichondrium and the clinical uses of perichondrial graft. How is the difference of thickness of the regenerated cartilage after crushing the free perichondrial graft, compare with uncrushed graft? In this study, the perichondrium was obtained from rabbit, ears, and sectioned 10x10 mm slices. The uncrushed and crushed perichondriums were grafted into subcutaneous layer of back. After the 2,4 and 8 weeks, authors obtained regenerated cartilage from both crushed and uncrushed free perichondrial graft from rabbit back, examined the survival rate and thickness by histologic study.The results are as follows: 1. The survival rate was no difference between the uncrushed perichondrium & crushed perichondrium (p>0.05). 2. The cartilage from the uncrushed perichondrium was thicker than the crushed perichondrium, at only 8 weeks(p<0.01). 3. The thickness of regenerated cartilage was similar to the cartilage of the donor site of free perichondrial graft at 4 weeks(p>0.05).
Cartilage* ; Ear* ; Humans ; Regeneration* ; Survival Rate ; Tissue Donors ; Transplants

Forty patients(9 male and 31 female) with tsutsugamushi disease were evaluated clinically. The diagnosis of tsutsugamushi disease was confirmed by indirect immunofluoresent test or isolation of causative agent. More than 77% of patients were over 40 years of age. After the incubation period(5 to 13 days, average 8 days) symptoms developed suddenly. The frequent symtoms were fever(100%), chill(100%), headache(100%), rnalaise(97%), and myalgia(95%). On physical exammination the rash, eschar, and lymphadenopathy were found in 97%, 82%, and 67% respectively. Eschar was observed in the trunk, especially axillary, abdominal and inguinal area. Serum transarninase(SGOT snd SGPT) was elevated(89 and 87%). Urinalysis revealed proteinuria in 35%(12/34) and hematuria in 19%(7/36). Chest roentgram and ECG demonstrated abnormalities in 39%(14/36) and 73%(26/36) respectively, The treatment with doxycycline was very effective in all cases.
Diagnosis ; Doxycycline ; Electrocardiography ; Exanthema ; Hematuria ; Humans ; Lymphatic Diseases ; Male ; Proteinuria ; Scrub Typhus* ; Thorax ; Urinalysis

PURPOSE: The purpose of this study was to evaluate and compare the scintigraphic findings and diagnostic accuracy of double-phase Tc-99m sestamibi scan in primary and secondary hyperparathyroidism (HPT). MATERIALS AND METHODS: We retrospectively reviewed 16 cases of primary (18 lesions) and 11 cases of secondary HPT (44 lesions) who underwent Tc-99m-sestamibi scan before the surgical intervention. Scan was performed using LEM camera (Siemens, Germany) after the injection of 740MBq of Tc-99m sestamibi. Routine image consisted of baseline and 3-hour delayed images and each image was obtained using both parallel and pine hole collimator. The study population was 27 patients (male/female=5/22, age: 49.1+/-10.8). RESULTS: Eighteen lesions of primary HPT consisted of 13 adenomas and 5 hyperplasias, while all lesions of secondary HPT were hyperplasias. Among the case of primary HPT, we could detect all the lesions of 13 adenomas but only 2 lesions of 5 hyperplasias (40%) could be detected by double phase scintigraphy. Three cases of primary lesion showed decreased uptake in delayed images compared with baseline. The sensitivity, specificity, positive predictive value and accuracy of primary and secondary HPT were 58.8% (10/17), 83.3% (10/12), 83.3% (10/12), 75.9% (22/29), and 37.5% (15/40), 50% (2/4), 88.2% (15/17), 38.6% (17/44), respectively. Overall sensitivity, specificity, positive predictive value and accuracy were 43.9% (25/57), 75% (12/16), 86.2% (25/29), and 53.4% (39/73). There were no statistical difference between the weight of primary and secondary HPT lesion (p>0.05). CONCLUSION: Tc-99m sestamibi scan is fairly good modality to detect parathyroid lesion in patient with primary HPT before the surgical intervention. However, since some of cases may reveal decreased uptake in delayed image, a careful attention to the findings of baseline images may be helpful. Still the low accuracy of sestamibi scan in diagnosis of secondary HPT prohibits routine use of it for this disease.
Adenoma ; Diagnosis ; Humans ; Hyperparathyroidism, Primary ; Hyperparathyroidism, Secondary* ; Hyperplasia ; Parathyroid Glands ; Radionuclide Imaging* ; Retrospective Studies ; Sensitivity and Specificity

TGF-beta1 expression was studied in 25 patients with tuberculosis (lung, 9 cases and lymph node, 16 cases) using a polyclonal antibody in formalin-fixed paraffin embedded tissue. Nineteen cases (76.0%) out of 25 cases showed TGF-beta1 expression. TGF-beta1 was present in cytoplasm of epithelioid cells and Langhans' giant cells. Pulmonary tuberculosis and tuberculous lymphadenitis showed different patterns of staining. Five of 9 cases of pulmonary tuberculosis were positive for TGF-beta1: four of acid-fast bacilli positive cases (4/5, 80.0%) and one of acid-fast bacilli negative cases (1/4, 25.0%). However, high expression of TGF-beta1 was detected in tuberculous lymphadenitis of both acid-fast bacilli positive group (3/4, 75.0%) and acid-fast bacilli negative group (11/12, 91.7%). TGF-beta1 was also expressed in all of 6 cases of BCG-induced tuberculous lymphadenitis: 2 acid-fast bacilli positive and 4 acid-fast bacilli negative cases. TGF-beta1 expression was shown in 19 cases (86.4%) of 22 in active tuberculosis, while no TGF-beta1 expression was detected in any cases of inactive, healed tuberculosis (p<0.008). This study supports that the TGF-beta1 expression of epithelioid cells may alter their function resulting in the impaired antimycobacterial activity. Thus the increased production of TGF-beta1 may be one of the important mechanisms by which Mycobacterium tuberculosis avoids destruction by host macrophages.
Cytoplasm ; Epithelioid Cells ; Giant Cells ; Granuloma* ; Humans ; Lymph Nodes ; Macrophages* ; Mycobacterium tuberculosis ; Paraffin ; Transforming Growth Factor beta1* ; Tuberculosis ; Tuberculosis, Lymph Node ; Tuberculosis, Pulmonary

Adenocarcinoma metastatic to the skin usually originates in the lung, breast, large intestine or ovary. Cutaneous metastatic tumors from rectum or colon tend to appear in the abdominal or perineal area, but rarely appear in the perianal and genital skin. A 53-year-old female presented multiple nodules in and near the surgical scars of inguinal, pubie, vulvar, perianal areas and normal skin of left thigh two months after surgical removal of rectal adenocarcinoma. Biopsy specimens from the nodules of the perianal area and left thigh showed adenocarcinoma of well differentiated atruetures like the primary rectal carcinoma.
Adenocarcinoma* ; Biopsy ; Breast ; Cicatrix ; Colon ; Female ; Humans ; Intestine, Large ; Lung ; Middle Aged ; Ovary ; Rectum ; Skin ; Thigh