A case of osteochondritis dissecans of both knee joints is developed in 15 year old boy. Since the original articles of Paget, Koning and others were reported, many theories as to etiology and pathogenesis have been proposed but exact cause has been unknown. Many Joint may show evidence of osteochondritis dissecans but lateral aspect of medial femoral condyle of knee is by far the most frequent site. Under the diagnosis of osteochondritis dissecans of both knees with clinical symptoms and X-ray finding, the one was treated with excision of framents and curettage, and the other treated with drilling of fragments. In follow up study for one year, the result was good without any complaints.
Curettage ; Diagnosis ; Follow-Up Studies ; Humans ; Joints ; Knee Joint ; Knee ; Male ; Osteochondritis Dissecans ; Osteochondritis

OBJECTIVE: To analyze the clinical characteristics of obese infertile women. MATERIAL AND METHOD: Height, weight, body mass index, menstrual pattern, glucose, insulin, glucose / insulin ratio, dehydroepiandrosterone sulfate (DHEA-S), testosterone, free testosterone and plasminogen activator inhibitor (PAI-1) of 15 obese infertile women were tested. RESULTS: Of 15 obese infertile women, the number of diabetes mellitus, hyperinsulinemia, and insulin resistance was 2 (13%), 2 (13%), 2 (13%), respectively. The incidence of increased DHEA-S, testosterone, and free testosterone was 7 (47%), 1 (7%), 6 (40%), respectively. Notably, all patients showed increased PAI-1. CONCLUSIONS: Obesity is associated with infertility as well as many kinds of health problems. Obesity is closely related to insulin resistance and it also causes hyperandrogenism. Increased PAI-1 is one of the important causes of thrombophilia. Consequently, in the workup of obese infertile patient, many aspects of health problems should be considered.
Body Weight ; Dehydroepiandrosterone Sulfate ; Diabetes Mellitus ; Female ; Glucose ; Humans ; Hyperandrogenism ; Hyperinsulinism ; Incidence ; Infertility ; Insulin ; Insulin Resistance ; Obesity ; Plasminogen Activator Inhibitor 1 ; Plasminogen Activators ; Testosterone ; Thrombophilia

The pathogeoesis of papulonecrotic tuberculid had been thought to be the result of hernatogenous dissemination from primary tuberculous focus of other organs. But, today, the existence of papulonecrotic tuberculid as a rare cutaneous reaction to the Mycobacterium bacillus is questioned. Papulonecrotic tuberculid is, however, a real entity in underdeveloped countries where tuberculosis is more common. We report a case having papulonecrotie tuberculid associated with cervical lymph node tuberculosis confirmed by typical histopathology and by clinical response to antituberculous chemotherapy. This case supports Iden et al's view (1) that skepticism regarding the existence of papulonecrotic tuberculid is probably the result of the current decreased prevalence of untreated tuberculosis and consequently increased rarity of this entity.
Bacillus ; Drug Therapy ; Mycobacterium ; Prevalence ; Tuberculosis ; Tuberculosis, Cutaneous* ; Tuberculosis, Lymph Node

Malignant angioendothelioma is an uncommon malignant vascular tumor featuring endothelial cell, and it occurs most frequently in sixth and seventh decade. Most lesions occur over the face and scalp, and may be solitary or multiple, The lesion usally appears as a localized dark red to purplish nodules or plapue with small satellite nodules. Histopatholgic finding shows a nodule eomposed of irregular vascular spaces lined by plump endothelial cells stroma. We present a case of malignant angioendo thelioma on a 42 year-old woman. The patient had purplish nodule with satellite lesions on the right cheek. This case was confirmed by clinical picture, histologic findings and electron microscopic examination.
Adult ; Cheek ; Endothelial Cells ; Female ; Humans ; Scalp

The brief report of Zeisler (1922) of a pregnant woman with scattered telangiectasia in a unilateral distribution is perhaps the first recorded case of this syndrome. The syndrome has been described in association with pregnancy, puberty, alcoholisrn and cirrhosis, hormonal therapy and congenital status. The authors observed in a 17-year-old male unilateral telangiectatic lesions over the left C, C, C, Tl and T, dermatomal regions. The lesions developed at first at his puberty on the anterior part of the chest as speckled bright red discoloration. Thereafter, the lesion has been progressed to involve the left upper extremity, sholder, upper middle part of the chest, eventually. Family history was negative and physical, lahoratory and X-ray examination were all negative or within normal limit. No mucous membrane involvement was observed. On histopathologic examination of the skin lesion, thin walled ectatic vessels lined with single layer of endothelial cells were observed in the upper dermis. The lesions were partly dermabrased with favorable result.
Adolescent ; Dermis ; Endothelial Cells ; Female ; Fibrosis ; Humans ; Male ; Mucous Membrane ; Pregnancy ; Pregnant Women ; Puberty ; Skin ; Telangiectasis* ; Thorax ; Upper Extremity

It is generally accepted that the integrity of posterior cruciate ligament plays a major role in knee stability. The rotatory movement is around a point to the back of center of joint where the posterior cruciate ligament lies, and it is a structure which is just as important as the other ligaments. Methods of reconstruction have been described, using semitendinosus tendon, gracilis tendon, popliteus tendon, patellar tendon, iliotibial band, and medial meniscus. We have successfully used the semitendinosus tendon in two patients who sustained neglected rupture of posterior cruciate ligament.
Humans ; Joints ; Knee ; Ligaments ; Menisci, Tibial ; Patellar Ligament ; Posterior Cruciate Ligament ; Rupture ; Tendons

Transeurethral Radiofrequency (TURF) Thermotherapy is a new acceptable treatment modality for benign prostatic hyperplasia. We treated 70 cases of BPH patients by TURF Thermotherapy (THERMEX-II). Among them, we got a follow-up observation on 37 patients (urinary retention: 16 cases, non-urinary retention:21 cases) each at 1 month and 3 months after treatment. Mean age of patients was 69.1 years and their mean prostatic weight was 40.5gr by transrectal prostatic ultrasonogram. All patients were treated single session for 2 hours without any sedation, and well tolerated with the temperature of 47-48degree. We evaluate patients with Boyarsky symptom score, urine flow rate, volume of residual urine and patient`s subjective symptoms before and after treat- The results were as follows ; 1. The mean Boyarsky symptom score was 15.4 before treatment, it became 9.9 at 1 month and 8.8 at 3 months after treatment. 2. In the retention patients : Mean maximal flow rate was 6.53ml/sec at 1 month. 8.47ml/sec at 3 months, and residual urine was 70ml at 1 month, 57ml at 3 months after treatment. 3. In the non-retention patients : Mean maximal flow rate increased from 4.74ml/sec to 10.29ml/ sec at 1 month. 10.76ml/sec at 3 months, and residual urine decreased from 60.7ml/ to 20ml at 1 month. 17.2ml at 3 months after treatment. 4. Complications were acute urinary retention (14.3% ) and gross hematuria (8.1%), but it was resolved by conservative treatment. There were no urinary tract infection, bladder spasm or other complications after treatment. We conclude TURF thermotherapy is one of the good and safe treatment in benign prostatic hyperplasia.
Follow-Up Studies ; Hematuria ; Humans ; Hyperthermia, Induced* ; Prostatic Hyperplasia* ; Spasm ; Ultrasonography ; Urinary Bladder ; Urinary Retention ; Urinary Tract Infections

PURPOSE: Gamma-globulin is effective in preventing coronary aneurysm, the primary complication of Kawasaki disease(KD). However, in order to predict high-risk cases which absolutely require gamma-globulin, because of its high expenses, Harada score(HS) was introduced in Japan in 1990. We attempted to compare HS scoring with the health insurance criteria currently used in Korea. METHODS: Retrospective studies were performed on 123 cases who did not receive gamma-globulin among 283 KD patients who had been treated in this hospital from 1990 to 1997. Chi-square analyses were used. RESULTS: Of the 123 subjects, 91(74%) had HS scores higher than 4, and 32(26%) had HS less than 4, whereas 56(45.5%) belonged to the high-risk group and 67(54.5%) to the low-risk group according to the insurance criteria, with both methods differing significantly(P<0.001). Of 18 cases with the coronary complications only 2 cases had an HS<4, whereas 4 patients belonged to the low-risk group. Even though both methods did not differ significantly in discriminating risky cases, twice as many patients may have been denied adequate treatment if the insurance criteria had been applied. Of various factors, the age and albumin level were found relevant to the coronary complication. CONCLUSION: No statistically significant difference was found between HS and the insurance criteria in predicting the incidence of coronary complications in 123 KD patients. But a less lenient criteria used in the current health insurance policy may result in more cases with coronary complications.
Coronary Aneurysm* ; gamma-Globulins ; Humans ; Incidence ; Insurance ; Insurance, Health ; Japan ; Korea ; Mucocutaneous Lymph Node Syndrome* ; Retrospective Studies

Avascular osteonecrosis has frequently occured in patients who have undergone transplantation of a kidney and generally has been considered to be a complication of the use of corticosteroids. But there are controversies regarding their dosage and duration of use in its influence on prevalence of avascular osteonecrosis. We analyzed the cases of our patients who underwent transplantation of a kidney and who we were able to follow up more than 8 months. l. Of a total of 300 patients, osteonecrosis developed in 24 joints of 12 patients. 2. Osteonecrosis was more frequently found in group of patients who were administered with larger doses of steroid. 3. Rejections of the transplanted kidney occured more frequently in those groups with osteonecrosis. 4. Most of rejections occured within 3 months after renal transplantation. 5. It took 4–26 months (average 12.3 months) the osteonecrosis could be found. 6. There were no differences in blood concentration of calcium phosphate and creatinine between osteonecrosis and non-osteonecrosis group. 7. Replacement arthroplasties were done in 10 joints without significant complication.
Adrenal Cortex Hormones ; Arthroplasty, Replacement ; Calcium ; Creatinine ; Follow-Up Studies ; Humans ; Joints ; Kidney ; Kidney Transplantation ; Osteonecrosis ; Prednisolone ; Prevalence

The tibial plateau fracture is a common fracture in the knee joint. Tibial plateau fracture involves most always the articulating cartilage and produce the disability of the knee joint oftenly. The 25 cases of tibial fractures have been classified by Hohls method and analysed their clinical courses more than three month period. The 13 cases out of 25 had treated in conservative method such as plaster of Paris with or without closed reduction. Remaining 12 cases were treated operatively due to the failure of closed reduction or associated injury of major ligaments. More than 8 mm of depression or 5 mm split of the plateau fragment is classified as failure of closed reduction. Excellent end result is obtained in 21 cases with free of pain on walking and full range of joint motion without instability and muscle weakness, Three cases were classified as Good result with occasional pain on walking, range of joint motion is available more than 0~90 degree and good grade of muscle power without instability. One case was poor in result with instability of joint and pain on walking. The radiological end result of accurate reduction of fragment is not closely correlated with functional result in the treatment of tibial plateau fracture. The most important factor in the treatment of tibial plateau fracture is the exercises of the joint as early as possible.
Calcium Sulfate ; Cartilage ; Depression ; Exercise ; Joints ; Knee Joint ; Ligaments ; Methods ; Muscle Weakness ; Tibial Fractures ; Walking