The origin of the popliteal cyst is the popliteal bursa and frequently combined with the intraarticular lesion. And open excision has been commonly used as a treatment. The authors reviewed 39 cases of popliteal cyst in 38 patients, mangaged with arthroscopic method at Department of Orthopedic Surgery, College of Medicine, Korea University Hospital from June 1989 to July 1993 and the following results were obtained. l. Among 39 cases, 35 cases(89.7%) were associated with intraarticular lesions of the knee joint; 25 cases(71.4%) were chondral injuries, 6 cases(17.1%) were meniscus tear, 2 cases(5.7%) were rheumatoid arthritis and 2 cases were plica syndrome. 2. 20 cases(51.2%) were shown to have the communication between cyst and joint. 3. During operation, position change of the patient and another draping was not necessary. And the blue stained wall enabled authors to remove more completely the popliteal cyst than other conventional operative procedures. 4. Becuase of the short skin incision, the operation time was saved and we were able to recommend early excercise of the knee joint and ambulation. The operative treatment of popliteal cyst with the arthroscopy is the one staged method to excise the cyst and to intervent the combined intraarticular pathology which develop the cyst, and is one of the recommendable method bacause of small skin incision, short hospitalization and early rehabilitation.
Arthritis, Rheumatoid ; Arthroscopy ; Hospitalization ; Humans ; Joints ; Knee Joint ; Korea ; Methods ; Orthopedics ; Pathology ; Popliteal Cyst ; Rehabilitation ; Skin ; Surgical Procedures, Operative ; Tears ; Walking

STUDY DESIGN: The authors analysed the recovery of clinical symptoms after percutaneous drainage and irrigation in pyogenic vertebral osteomyelitis. OBJECTIVES: To determine the role of percutaneous drainage and irrigation in pyogenic vertebral osteomyelitis. SUMMARY OF LITERATURE REVIEW: Pyogenic vertebral osteomyelitis is a relatively rare condition but its incidence is recently increasing due to common use of intravenous access devices and resultant nosocomial bacteremia. Management of the disease is not uniform and is controversial regarding the role of surgery and duration of use of antibiotics. At present, the role of percutaneous drainage of involved spines in treatment of pyogenic vertebral osteomyelitis is not well-known. MATERIALS AND METHODS: We report 3 cases of pyogenic vertebral osteomyelitis which were treated by continuous drainage with automated percutaneous lumbar discectomy device(APLD device) and draining tube after they haute failed to conservative treatment. APLD device, fluoroscopic guide, contrast media and continuous percutaneous draining tubes were used for this procedure. The percutaneous draining tubes were maintained for 7 to 11 days and each case was followed up for 6 to 10 weeks under admission. RESULTS: Symptoms were relieved 3 to 5 weeks after this procedure. The patients were followed up to 12 to 39 months and experienced no recurrence. CONCLUSIONS: Percutaneous drainage and irrigation with APLD device brought prompt and marked clinical recovery. It is indicated as a supplementary method to conservative treatment or in case of high operative risk patient due to poor general conditions. It has minimal invasiveness, short clinical course and low recurrence rate.
Anti-Bacterial Agents ; Bacteremia ; Contrast Media ; Diskectomy ; Drainage* ; Humans ; Incidence ; Osteomyelitis* ; Recurrence ; Spine

No abstract available.
Brain* ; Child* ; Humans

The single enzyme P-450c17 hydroxylase catalyzes the 17a-hydroxylation of both pregnenolone and progesterone and the side-chain cleavage of 17a-hydroxypregnenolone and 17a-hydroxypro- gesterone to dehydroepiandrosterone and androstenedione. This enzyme is located in the endoplasmic reticulum and consists of a P-450c17 and a specific flavoprotein NADPH-cytochrome P-450 reductase. The clinical picture and hormonal pattern in 17a-hydroxylase deficiency have been consistent in both genotypic sexes with hypergonadotropic hypogonadism in whom the virtual absence of gonadal steroids results in a female phenotype with primary amenorrhea and pseudohermaphro- ditism in the male and underdeveloped secondary sex characteristics and hypermineralocorticoidism with hypertension, hypokalemia, suppressed renin-angiotensin system and extremely reduced aldo-sterone production. A 17-year-old girl visited endocrine clinic because of amenorrhea, absence of pubic and axillary hair, and hypertension. she had elevated levels of serum corticosterone, deoxycorticosterone(DOC), 18-hydroxycorticosterone(18-OHB). Stumulation with ACTH effected minimal increase in the elevated steroids and the ACTH-stimulated 18-OHB to aldosterone ratio was more than 280. These hormonal patterns appear to be homozygote in 17a-hydroxylase deficiency.
Adolescent ; Adrenocorticotropic Hormone ; Aldosterone ; Amenorrhea ; Androstenedione ; Corticosterone ; Dehydroepiandrosterone ; Endoplasmic Reticulum ; Female ; Flavoproteins ; Gonads ; Hair ; Homozygote ; Humans ; Hypertension ; Hypogonadism ; Hypokalemia ; Male ; Oxidoreductases ; Phenotype ; Pregnenolone ; Progesterone ; Renin-Angiotensin System ; Sex Characteristics ; Steroids

It has been proven that the newborn screening programs for congenital hypothyroidism are very important for its early detection and the early treatment of congenital It has been proven that the newborn screening programs for congenital hypothyroidism are very important for its early detection and the early treatment of congenital hypothyroidism can ameliorate and possibly reverse its consequences. Treatment with L-thyroxine is started in case of suspicious hypothyroidism at the first visit. Serum concentration of total and free thyroxine become normal within 1week after start of therapy but TSH values become normal from 2 months to 6 months after L-thyroxine therapy. The possible explanations for prolonged TSH elevation in congenital hypothyroidism are poor compliance for therapy, an inadequate dose of L-thyroxine, elevated threshold for thyrotropin suppression and two novel mutations in the thyrotropin (TSH) receptor gene in a child with resistance to TSH. Authors have experienced two cases of prolonged TSH elevation with normal T3 and T4 levels till 18months and 27 months of age after optimal L-thyroxine therapy and literature were reviewed.
Child ; Compliance ; Congenital Hypothyroidism* ; Humans ; Hypothyroidism ; Infant, Newborn ; Mass Screening ; Thyrotropin ; Thyroxine

No abstract available.
Hematoma*

BACKGROUND: Genus of Aspergilli are ubiquitous saprophytic molds in nature, but its change from a saprophytic fungus to a pathogenic organism has occurred since the use of various antibiotics. The fungus affects the chronically ill and debilitated population. Recently frequency of the fungal infection is increasing in Korea with abuse of antibiotics and glucocorticoids. METHOD: We analyzed medical records of 52 patients with pulmonary aspergillosis seen at Hanyang University Hospital from 1980 to 1994. The results were as follows; RESULTS: 1) Ages ranged between second to eighth decades with majority(50%) in the fourth to fifth decades. The male to female ratio was 1.1:1. 2) Hemoptysis and productive cough, the leading symptoms, occurred in 42.3% and 25% respectively. 3) On chest X-ray fingings, the characteristic 'fungus ball' pattern were observed in 53.8% of the 52 cases. 4) Sputum culture for aspergilli were positive in 21.6% of the cases. We performed foe needle aspiration in 22 patients and the diagnostic yield was 100%. 5) Thirty-six patients had history of treatment with antituberculous drugs under diagnosis of pulmonary tuberculosis for an average of 27.3 months. But sputum analysis for acid-fast bacilli were positive in 5.6%(2cases of 36cases), and postoperative pathologic findings showed that 38.9% (12 cases of 28cases) were combined with tuberculosis. 6) Right upper and left upper lobes were predominantly involved(34.6% and 19.2% respectively) and lobectomies were performed in 21 cases. 7) Underlying diseases were present in 47 cases and 48.9% of them were pulmonary tuberculosis. CONCLUSION: These results showed that pulmonary aspergillosis usually develops in patients with open cavitary pulmonary tuberculosis. And we must consider the possibility of pulmonary aspergillosis in a patient with hemoptysis and cavitary lung lesion.
Anti-Bacterial Agents ; Aspergillus ; Chronic Disease ; Cough ; Diagnosis ; Female ; Fungi ; Glucocorticoids ; Hemoptysis ; Humans ; Korea ; Lung ; Male ; Medical Records ; Needles ; Pulmonary Aspergillosis* ; Sputum ; Thorax ; Tuberculosis ; Tuberculosis, Pulmonary

No abstract available.

We have examined the regenerative capabilities of the human scalp hair follicle after grafting the lower half of the follicle. Twenty-eight of 32 intact whole-hair follicles isolated from the human scalp regenerated hairs when grafted onto the forehead of the same person. Seven of the 15 lower-half follicles regenerated complete hair follicles 8 months after grafting showed that the lower-half follicle implant reconstituted the complete hair follicle. The sebaceous gland was not regenerated, but there was an outgrowth in the sebaceous gland regPark ion. Some grafts formed epithelial cysts. Two years after grafting, the histological examination of the regenerated follicle from the lower-half implant showed that the sebaceous gland was completely regenerated. While an intact follicle shows prominent naked shaft outgPark Park Parkrowth, the sheath grows concomitantly with the shaft in lower-half follicles in culture. If grafted lower-half follicles were located too deep, the regrown sheath could not reach the epidermal layer. In this situation, the formation of an epidermal cyst was likely.
Epidermal Cyst ; Forehead ; Hair Follicle* ; Hair* ; Humans ; Scalp ; Sebaceous Glands ; Transplants*

No abstract available.
Child* ; Diabetes Mellitus* ; Humans ; Insulin* ; Sex Hormone-Binding Globulin*