In the treatment of proximal tibial condyle fracture, it should be considered that it can often accompany injuries of the collateral ligament, both cruciate ligament, and the menisci of the knee. Moreover it is necessary to restore anatomical congruity of the articular surface accurately. We performed reduction of the depressed articular fragment under monitoring of arthroscopy and fixed with cannulated cancellous screws and accompanied by bone graft under the control of image intensifier in 2 cases of Type I(Pure cleavage) and 3 cases of type II(cleavage with depression) fractures. The results were very satisfactory. Arthroscopy assisted reduction and fixation are very useful method in the treatment of proximal tibial condyle fracture because of (1) the minimized operative morbidity, (2) the ability to evaluate and manage associated intraarticular pathology simultaneously, (3) the rapid rehabilitation, (4) the achievement of good reduction comparable to open reduction.
Arthroscopy ; Collateral Ligaments ; Knee ; Ligaments ; Methods ; Pathology ; Rehabilitation ; Transplants

Owing to the advancement of imaging techniques which include the CT scan, it became easier to evaluate fracture patterns of calcaneal fractures accurately. Moreover, it is possible to obtain good results with operative treatment as a consequence of the development of good operative equipment and new operative technique. In 1988, Regazzoni and Benirschke in 1990, recommended L-shaped extensive lateral approach for calcaneus which provide extensive exposure of calcaneus and so allow easier reduction and fixation. We carried out L-shaped extensive lateral approach in 11 cases from June, 1993 to April, 1994. This approach did not produce any skin problems and allowed excellent anatomical reduction and fixation. But we experienced some severe causalgia on the heel region in several cases. We tried to analyse the cause of pain and concluded that it was the damage to the lateral calcaneal branch of the sural nerve. We are reporting the problems of tbis approach.
Calcaneus ; Causalgia ; Heel ; Skin ; Sural Nerve ; Tomography, X-Ray Computed

A 63-year-old Korean man presented with generalized, asymptomatic, discrete papules and coalescent annular plaques for one year. Interestingly, the patient complained of conjunctival congestion, concurrently with aggravation of the skin lesion. Histopathologic findings of the skin lesion and conjunctiva revealed giant cells engulfing fragmented elastic fibers, and a diagnosis of actinic granuloma with ocular involvement was made. Ten months later, the patient revisited with a two-week history of bilateral temporal headache, neck pain, intermittent jaw claudication, and blurred vision. Biopsy of the temporal artery confirmed the clinical diagnosis of temporal arteritis. Both actinic granuloma and temporal arteritis show similar pathologic process, and this case supports the hypothesis that actinically degenerated elastic tissue is likely to be the antigenic basis of actinic granuloma of the skin and temporal arteritis.
Actins* ; Biopsy ; Conjunctiva ; Diagnosis ; Elastic Tissue ; Estrogens, Conjugated (USP) ; Giant Cell Arteritis* ; Giant Cells ; Granuloma* ; Headache ; Humans ; Jaw ; Middle Aged ; Neck Pain ; Skin ; Temporal Arteries

To date, there are limited data and little consensus on treatment strategies for huge hepatocellular carcinoma (HCC). Surgical resection provides significantly better survival than other modalities for single large HCC regardless of tumor stage. Recently, with technological advances in radiation therapy, stereotactic body radiation therapy (SBRT) is considered an alternative treatment option for HCC. Herein, we present a case of huge HCC that was successfully managed by SBRT. Transarterial embolization, previously performed in Russia, was incomplete. It was also not suitable for resection and transarterial chemoembolization. Although the rationale for radiotherapy in huge HCC was insufficient, SBRT was performed because no other treatment options were available. Additional radiofrequency ablation was performed for small HCC in a different segment, and radiological complete response (CR) was achieved. The CR was maintained over 4 years. Therefore, SBRT may be an alternative treatment option for large HCC that is not suitable for curative treatment.

Menetrier's disease is a rare, characterized by the presence of large rugal folds involving part or all of the stomach. Patients with hypertrophic gastropathy often have distressing abdominal symptoms, weight loss, and edema due to gastric protem loss. A 64 year old male patient was admitted with the chief complaint of epigastric discomfort. Endoscopic, radiologic and histologic examination, revealed characteristic findings of Menetrier's disease. A case of Menetrier's disease is reported with a brief review of literature.
Edema ; Gastritis, Hypertrophic* ; Humans ; Male ; Middle Aged ; Stomach ; Weight Loss

No abstract available.
Carcinoma, Squamous Cell*

The purpose of treatment for metastatic spine tumor is to improve the quality of life. So, it is very important to carefully select the surgical candidates to prevent unnecessary surgery-related morbidity and mortality. For this purpose, the authors have surveyed 200 cases of spinal metastasis treated by radiotherapy alone or radiotherapy plus surgery to determine prognostic factors. In this study, we attempted to examine retrospectively the four factors, e.g.,primary tumor, pretreatment neurologic status, general condition and degree of cancer extension, affecting the prognosis of metastatic spine tumors. Each factor was ranked from 1 to 3 points according to the severity and the total score for each patient was obtained by adding the these points. As a result, it was found that the total score was highly correlated to the survival period. While the patients with a total score of 6 or lower survived 100 days or less, those of 10 or higher survived 300 days or more on average. Therefore, authors believe this scoring system would be helpful to the determine treatment modalities and the selection of the most suitable operative procedures.
Humans ; Mortality ; Neoplasm Metastasis ; Prognosis ; Quality of Life ; Radiotherapy ; Retrospective Studies ; Spine* ; Surgical Procedures, Operative

External beam radiotherapy, transarterial chemoembolization and sorafenib are currently standard treatments for advanced hepatocellular carcinoma (HCC) with portal vein thrombosis. However, hepatic arterial infusion chemotherapy has been applied to advanced stage HCC with a view to improving the therapeutic effect. We experienced a case of advanced HCC with clinical complete response after hepatic artery infusion chemotherapy and radiation therapy and report that.
Carcinoma, Hepatocellular* ; Chemoradiotherapy ; Drug Therapy* ; Hepatic Artery* ; Portal Vein* ; Radiotherapy* ; Thrombosis* ; Venous Thrombosis

Malignant peripheral nerve sheath spinal tumours are relatively rare. A primary spinal location at the first onset is rarely reported in the literature, thus the clinical features and therapeutic results of these spinal malignant tumours are not defined. We describle three patients with primary spinal malignant schwannomas and stress the surgical mananement of these cases.
Humans ; Neurilemmoma* ; Peripheral Nerves

OBJECTIVE: To evaluate the expressions of Ki-67, p53 and p21 waf1/cip1 according to the age and the histologic type of preinvasive and invasive cervical lesions. MATERIAL AND METHOD: Microwave-oven-processed formalin-fixed, paraffin-embedded, cervical biopsy specimens and hysterectomy specimens were obtained from 1997 to 1998 at the Soonchunhyang university Chunan hospital. These included 55 cervical intraepithelial neoplasm(CIN I-III), 14 invasive squamous cell carcinoma and 3 adenocarcinoma, and immunohistochemically evaluated by monoclonal MIB-1 antibody, monoclonal p53 antibody, and monoclonal p21 antibody. Positive index was expressed as a percentage of strong staining cells per 300 counted cells in evenly strong staining area. RESULT: Ki-67, p53 and p21 protein were expressed in the nuclei. Ki-67 was specifically expressed in all phases of cell cycles in proliferating cells. p21 expression was not seen in CIN I and CIN II, but was increased with increasing histologic grade. According to the age, Ki-67 expression was significantly higher in 30 > or =aged group than 30 < or = aged group, but p53 expresson was not significantly different according to age groups, and p21 expression was significantly lower in 50 < or = aged group than 30 > or =aged group. CONCLUSION: Conclusions of this study indicate that cell proliferating rate is higher in young age groups than old age groups. p53 expression was not significantly different according to age and histologic grade. These indicates that mutation of the p53 gene may be associated with the development of cervical cancer, but not associated with the progression of cervical cancer. Besides, p21 expression was increased in increasing histologic grade, but decreased in old aged women. Further study of this paradoxical increase in p21 expression in cervical carcinoma is necessary to clarify the mechanisms of p53 indepent pathway.
Adenocarcinoma ; Biopsy ; Carcinoma, Squamous Cell ; Cell Cycle ; Cell Proliferation* ; Chungcheongnam-do ; Female ; Genes, p53 ; Humans ; Hysterectomy ; Uterine Cervical Neoplasms