Pigmented villonodular synovitis is a kind of benigh inflammatory lesion involving synovial membrane, characterized by yellowish or yellow-grayish colored villous nodules of synovial membrane, formed by accumulation of cholesterol and hemosiderin with numerous cleftings of synovial membrane. The lesion was first described by Chassaignac (1852) as the nodular form arising in relation to the flexor tendon sheath of the middle and index fingers. After that Simon (1865) described it as a xanthoma of the synovia, and there after various names were given by many authors, according to the characteristics of the pathologic fetures. In 1941 Jaffe named this lesion pigmented villonodular synovitis, which is now generally accepted. Still the direct cause of this lesion is not clearly known, but chronic stimulation of synovia is generally accepted as an etiologic factor. In this paper we report four cases of pigmented villonodular synovitis, which were diagnosed and treated in our department. One of the four cases occurred at the proximal tibiofibula joint which is a very rare site.
Cholesterol ; Fingers ; Hemosiderin ; Joints ; Synovial Fluid ; Synovial Membrane ; Synovitis, Pigmented Villonodular ; Tendons ; Xanthomatosis

The femur is the largest long bone in the body which is related to weight bearing. As a result of rapid increase in traffic accidents and industrial injuries, the incidence of femoral shaft fractures has risen also. The methods of treatment in children and adults are different, therefore inadequate treatment can cause permanent disability. The authors have reviewed 211 cases of femoral shaft fractures in 204 persons (children and adults) from September 1967 to September 1976 whe were admitted and treated in Orthopedic Department, Severance Hospital. The results were as follows: 1. The fractures occured commonly in the 6–10 yr. age group (41.2%) in children and in the 21–40 yr. group (54.2%) in adults. Males comprised 138 cases (67.6%). 2. Closed fractures were 185 cases (87.7%) and comminuted fractures were the most common type, 94 cases (44.5%) in all. The fracture site was middle third in 116 cases (55%). 3. Causes were mainly car accidents, 146 cases (71.5%) and industrial injuries. Pedestrian injuries are particularly common in Korea. Many industrial accidents occur due to inadequate working facilities in factories. 4. Associated injuries were common in young adults and in order of frequency these were fractures of the tibia and fibula; skulls; pubic bone. 5. In the early and delayed operation groups, primary bony union rate was better (92%) in the early than the late operation group (78.3%). 6 The period of bony union was 13 weeks with compression plate and screw fixation: 16 weeks with Kuntscher nailing; 17. 5 weeks with plate and screw fixation; and 20 weeks with skeletal traction in adults. 7. Knee joint motion was most limited with skeletal traction (33.5%), less with plate and screw fixation (14.7%) and Kuntscher nailing (1.7%), but none with compression plate and screw fixation. 8. Good results were obtained with conservative treatment in children and operative treatment in adults. 9. Complications were much less frequent in children than in adults and were treated well. 10. Post-operative infection rate was 4.4% and infection was treated well with conservative measures. 11. The 90° – 90° skeletal traction in children and compression plate and screw fixation along with cast brace in adults were recommended.
Accidents, Occupational ; Accidents, Traffic ; Adult ; Braces ; Child ; Clinical Study ; Femur ; Fibula ; Fractures, Closed ; Fractures, Comminuted ; Humans ; Incidence ; Knee Joint ; Korea ; Male ; Orthopedics ; Pubic Bone ; Skull ; Tibia ; Traction ; Weight-Bearing ; Young Adult

BACKGROUND: The purpose of this study was to compare prospectively two different anesthetic techniques with isoflurane or propofol for postoperative nausea, vomiting and recovery after tonsillectomy in children. METHODS: Sixty children, ASA physical status I, were assigned randomly to one of two groups. In group I, anesthesia was induced with thiopental 5 mg/kg and maintained with isoflurane 1~1.5 vol%. In group P, anesthesia was induced with fentanyl 1 mcg/kg, propofol 2 mg/kg and maintained with propofol infusion 5~10 mg/kg/hr. Both group received vecuronium 0.1 mg/kg for tracheal intubation and were ventilated with 33% O2 in N2O. The time to extubation, time to eye opening, PACU time, incidence and numbers of postoperative nausea and vomiting, and degree of sedation were recorded as well as perioperative complications. RESULTS: There were no significant difference in the duration of anesthesia and PACU time between two groups. The time to extubation and eye opening of group P were significantly shorter than group I (p<0.05). The degree of sedation and incidence of postoperative nausea and vomiting of group P were significantly lower than group I (p<0.05). But the frequency of intraoperative bradycardia was significantly higher in group P than group I (p<0.05). CONCLUSIONS: Propofol-fentanyl anesthesia results in less nausea and vomiting during postoperative period and more rapid recovery compared to isoflurane anesthesia and may be recommended in children undergoing tonsillectomy and adenoidectomy.
Adenoidectomy ; Anesthesia* ; Bradycardia ; Child* ; Fentanyl ; Humans ; Incidence ; Intubation ; Isoflurane* ; Nausea ; Postoperative Nausea and Vomiting* ; Postoperative Period ; Propofol* ; Prospective Studies ; Thiopental ; Tonsillectomy* ; Vecuronium Bromide ; Vomiting*

Disseminated intravascular coagulation (DIC) is a pathological syndrome in which activation of coagulation cascade leads to fibrin clot formation, consumption of platelets and coagulation factors, and secondary fibrinolysis. We report a case of severe postoperative hemorrhagic diathesis due to DIC. A 59-year-old man was scheduled for reduction of tibia fracture and anatrophic nephrolithotomy of staghorn calculi. On the fifth postoperative day, second operation was performed for nephrectomy due to perirenal hematoma. Two days later, third operation was performed for hemostasis because of the continuous bleeding. Coagulation tests showed positive DIC profiles of thrombocytopenia, hypofibrinogenemia, increased fibrin degradation products, and prolonged prothrombin time and thrombin time. The patient recovered uneventfully and discharged on the 59th postoperative day.
Blood Coagulation Factors ; Calculi ; Dacarbazine ; Disseminated Intravascular Coagulation* ; Fibrin ; Fibrin Fibrinogen Degradation Products ; Fibrinolysis ; Hematoma ; Hemorrhage* ; Hemorrhagic Disorders ; Hemostasis ; Humans ; Middle Aged ; Nephrectomy ; Postoperative Complications ; Prothrombin Time ; Thrombin Time ; Thrombocytopenia ; Tibia

BACKGROUND: Pertechnetate ( Tc) has been widely employed for thyroid imaging. While pertechnetate and radioiodide have usually similar results in identifying thyroid nodules, occasionally differences have been noted. We intended to observe that the thyroid nodules which appeared to be hot on pertechnetate and to compare them with the images by radioiodide. METHODS: 'I scan was performed to thirty-eight cases (mean age: 48.9 +/- 13.2) presenting as hot nodule on Tc scan. Thyroid function test and pathologic diagnosis were obtained in all patients. RESULTS: Of the 38 patients, 24 had euthyroidism, 13 had hyperthyroidism, and 1 had hypothyroidism. Thirty patients had adenomatous goiter, 4 papillary carcinoma, 3 Hashimotos thyroiditis, and 1 had HQrthle cell tumor. 28 of 38 patients showed similar images, but the remaining 10 patients(26.3%) revealed discordant images on Tc and 131I scan. Among the concordant cases, 23 had adenomatous goiter, 3 had papillary carcinoma, and 2 had Hashimotos thyroiditis. Among the discordant cases, 7 had adenomatous goiter, 1 had papillary carcinoma, 1 had Hashimotos thyroiditis, and 1 had HQrthle cell tumor. The incidence of malignancy was 10.7% of concordant cases, and 20% of discordant cases and was revealed statistically insignificant (p>0.05). CONCLUSION: We observed higher incidence of malignancy in patients presenting hot nodules on 99mTc scan than ever reported. Fine needle aspiration should be performed to all patients with hot nodules and the 'I scan would not be recommended for further diagnostic study.
Biopsy, Fine-Needle ; Carcinoma, Papillary ; Diagnosis ; Goiter ; Humans ; Hyperthyroidism ; Hypothyroidism ; Incidence ; Sodium Pertechnetate Tc 99m ; Thyroid Function Tests ; Thyroid Gland* ; Thyroid Nodule ; Thyroiditis

PURPOSE: To evaluate the effects of oral Tamoxifen only versus L-Carnitine plus Tamoxifen in patients with Peyronie's disease. MATERIALS AND METHODS: All 45 patients with Peyronie's disease, diagnosed using accepted definitions, were randomized into two groups and treated for 3 months with Tamoxifen only(40 mg/day)(n=17) or a combination ofL-Carnitine(2 g/day) and Tamoxifen(40 mg/day)(n=28). A medical history was obtained, and a physical examination was performed. Plaque size, pain, erectile function(IIEF score), and penile curvature were assessed. Both before and after therapy, the differences between the 2 groups were compared using independent-sample t-test with p<0.05 considered significant. RESULTS: The mean age of the 45 patients was 52.1 years, and no severe adverse events occurred in either group. In the Tamoxifen only group, the mean decrease of plaque-length was 0.46+/-0.88 mm, and mean reduction in the pain rating scale was 0.44+/-0.53. In the L-Carnitine and Tamoxifen group, mean decrease of plaque-length was 1.57+/-0.92 mm, and mean reduction in the pain rating scale was 1.27+/-0.96. Based on IIEF scores, the improvement of erectile function was 0.88+/-0.64 in the Tamoxifen only group and 1.56+/-0.75 in the L-Carnitine and Tamoxifen group. The degree of penile curvature was also measured, and the reduction of curvature angle was 9.17+/-4.92 degrees in the Tamoxifen only group and 9.55+/-6.50 degrees in the L-Carnitine and Tamoxifen group. CONCLUSIONS: This study showed significantly greater improvements in plaque size, pain, erectile function, and curvature in patients with Peyronie's disease who were treated with L-Carnitine and Tamoxifen compared with those treated with Tamoxifen only.
Carnitine* ; Humans ; Male ; Penile Induration* ; Physical Examination ; Tamoxifen*

Short umbilical cord syndrome, also known as the limb-body wall malformation complex and the body stalk anomaly, is a poorly defined sporadic group of congenital anomaly charaterized by a complex set of disruptive abnormalities having in common the failured closure of the ventral body wall. This disorder is charaterized by a short or absent umbilical cord and disruption of the lateral body wall, spine, limbs, face, and cranium, isolated or in combination. Recently, we present a case of short umbilical cord syndrome which found in a term baby, so we report a case of short umbilical cord syndrome with brief review of literature.
Extremities ; Skull ; Spine ; Umbilical Cord*

No abstract available.
Animals ; Calcium ; Rats* ; Urinary Bladder*

Despite the low incidence of adrenal involvement from renal cell carcinoma, ipsilateral adrenalectomy continues to be a standard part of radical nephrectomy at most medical centers. We reviewed retrospectively 51 patients treated with standard radical nephrectomy and 36 patients treated with modified radical nephrectomy sparing the ipsilateral adrenal gland. Histopathology confirmed malignant involvement of the adrenal in one patient who had evidence of adrenal involvement on the preoperative CT scan, and 50 patients who were normal on the preoperative CT scan didn`t have malignancy on their adrenal specimens. There were no malignant involvement of the adrenal on follow-up CT scan in 36 patients treated with sparing their adrenal and didn`t affected their prognosis and survival. These findings suggest that the ipsilateral adrenal gland need not be removed routinely as part of perifascial nephrectomy for renal cell carcinoma. For patients with middle and lower pole localized renal cell carcinoma who have normal findings on preoperative CT scans, modified radical nephrectomy sparing the adrenal gland may be a surgical alternative to radical nephrectomy.
Adrenal Glands ; Adrenalectomy* ; Carcinoma, Renal Cell ; Follow-Up Studies ; Humans ; Incidence ; Nephrectomy* ; Prognosis ; Retrospective Studies ; Tomography, X-Ray Computed

No abstract available.
Prostate* ; Prostatectomy* ; Prostatic Neoplasms*