Primary papillary serous carcinoma of the peritoneum(PPSCP) is vere rare. It has been suggested that PPSCP derives from embryonal coelomic epithelium with m llerian ducts potential. PPSCP can develop from a single or multicentric focus. The clinical and histologic disease entities are similar to those of primary papillary serous carcinoma of the ovary, but PPSCP involves the ovarian surface only minimally(microscopic disease) or spares the ovaries entirely. We have experienced a case of primary papillary serous carcinoma of the peritoneum and report this case with brief review of the concerned literature.
Epithelium ; Female ; Ovary ; Peritoneum*

Leukocytosis and neutrophilia is common during the acute phase of Kawasaki disease whereas leukopenia is not common and severe neutropenia is rare. Severe neutropenia is defined as absolute neutrophil count less than 500/mm3. There are only few publicatons reporting of atypical Kawasaki disease with severe neutropenia. We report a case of atypical Kawasaki disease with severe neutropenia.
Leukocytosis ; Leukopenia ; Mucocutaneous Lymph Node Syndrome* ; Neutropenia* ; Neutrophils

Castleman's disease is a benign disorder characterized by hypervascular lymphoid hyperplasia. The etiology of the disease is still unknown. Although it may occur at the various sites such as peritoneum, retroperitoneum, pelvic lymph node, muscle and lung, it occurs most commonly at the mediastinum. Even though specific pathophysiologic relations are still not clearly determined between two different histologic types -hyaline vascular type and plasma cell type-, there were several previous reports dealing with the plasma cell type transformed or progressed into different types of malignancies such as malignant lymphoma, Kaposi's sarcoma and Hodgkin's disease. We experienced a case of plasma cell type Castleman's disease that transformed into a malignant lymphoma and report this case with review of literatures.
Giant Lymph Node Hyperplasia* ; Hodgkin Disease ; Hyperplasia ; Lung ; Lymph Nodes ; Lymphoma* ; Mediastinum ; Peritoneum ; Plasma Cells* ; Plasma* ; Sarcoma, Kaposi

No abstract available.
Peptic Ulcer*

PURPOSE: To evaluate the bone tunnel enlargement after an anterior cruciate ligament reconstruction (ACLR), We compared the results between a group that had a bone-patellar tendon-bone (BPTB) autograft (group 1) that included the nubbin and one that had a hamstring double looped autograft (group 2). MATERIALS AND METHODS: We evaluated 120 knees over a one year follow-up period. In group 1, the tibial tunnel was completely filled with nubbin. The clinical results were evaluated using the IKDC knee rating system and a KT-2000 arthrometer. Changes in the bone tunnel width on ordinary radiographs were measured periodically. RESULTS: Clinically, there was no significant difference between the two groups. In group 2, more tunnel enlargement occured (p<0.05). ACLR that included the nubbin in the BPTB autograft showed better results in the tunnel enlargement than the others. CONCLUSION: ACLR using the nubbin at the BPTB autograft is one of the solutions available for prevention of bone tunnel enlargement after ACLR.
Anterior Cruciate Ligament Reconstruction* ; Anterior Cruciate Ligament* ; Autografts ; Follow-Up Studies ; Knee

PURPOSE: Up to now, there are several controversies in many aspects of osteochondritis dissecans. In this paper, we have intended to evaluate the frequent location and the etiology of the osteochondritis dis-secans of the femoral condyles, and to assess the adequate modality of operative treatment and its results according to the modality. MATERIALS AND METHODS: We reviewed retrospectively forty-four knees in forty patients. We analysed their clinical and radiological finding to take the incidence at both condyles and its etiology and to estab-lish the modality of applied operative methods according to the status of the lesion. The performed operative methods were multiple drilling(1 case), fragment fixation(2 cases), curettage & multiple drilling(36 cases), osteochondral autotransplantation(5 cases). The majority of these operation was proceeded under arthroscopy. Its clinical results were assessed by Aichroth's result grading system after an average follow-up of two-years and eleven months(range, one year and two months to six years and one month). RESULTS: Twenty one cases were medial femoral condylar lesions, and 23 cases were lateral. 91% patients had had the history of the definitive trauma(20 cases) or the minor repetitive trauma in their envi-ronments(20 cases). After operative treatment, seven knees had an excellent result; twenty-nine, a good result; six, a moderate result; and two, a poor result. Satisfactory result was 82%. CONCLUSIONS: On the basis of this review, we suggest that there is no difference in incidence between both femoral condyles, and that the trauma is seemed to play a major role as an etiologic factor. Majority of operated patients showed satisfactory results after application of our treatment modality.
Adult* ; Arthroscopy ; Curettage ; Follow-Up Studies ; Humans ; Incidence ; Knee ; Osteochondritis Dissecans* ; Osteochondritis* ; Retrospective Studies

PURPOSE: To evaluate the radiological findings of abdominal malignant fibrous histiocytomas. MATERIALS AND METHODS: We retrospectively reviewed the radiological findings of 13 masses in seven patients including two patients with multiple masses. The masses were located at the mesentery and omentum in three patients and at theretroperitoneum in four. Gastrointestinal examination using barium was performed in four patients, ultrasonographyin five and computed tomography in all. RESULTS: The average diameter of masses was 7.8cm(range : 1-20cm); plain abdominal films revealed soft tissue masses in all patients. Three of four barium studies demonstrated only displacement of bowel loops and the other showed findings of submucosal tumor. Eight of 11 masses were detected on ultrasonography and all were round or lobulated and had well defined margins. Four of these masses were greater than 8cm in diameter and showed homogeneous echogenicity with central hypo or anechoic area ; the remaining wereless than 8cm and showed relatively homogeneous echogenicity. On computed tomography, all 13 masses were seen as highly enhanced and well circumscribed. Seven were greater than 5cm in diameter and had internal low-densityareas. Peritumoral vessel-like structures were seen in eight masses and on plain abdominal radiograph and computed tomogram, calcification was seen in one patient. In no patient was combined retroperitoneal or intraperitoneal lymphadenopathy noted. CONCLUSION: Abdominal malignant fibrous histiocytomas are well-circumscribed, round orlobulated bulky masses with frequent necrosis and occasional calcification. Characteristically, there is nocombined lymphadenopathy and multiple masses are a rare manifestation. These findings may be helpful in the diagnosis of malignant fibrous histiocytoma.
Barium ; Histiocytoma, Malignant Fibrous* ; Humans ; Lymphatic Diseases ; Mesentery ; Necrosis ; Omentum ; Retrospective Studies

PURPOSE: There is increasing concern about ethical conduct of human research in the field of medicine. The purpose of this study was to assess the ethical review process by institutional review boards for human research articles published in the journal of Korean Society of Emergency Medicine. METHODS: We reviewed human research papers published in the journal of Korean Society of Emergency Medicine from the 1st edition, 1990 to the 6th edition, 2006. A checklist was used to review the articles. RESULTS: The total number of prospective clinical research paper was 250. Among them, there were 63 papers (25.2%) in which the obtaining of informed consent was described in the article. Only two studies (0.8%) published in the journal were noted to have IRB approval. Invasive techniques were employed in 134 studies (53.6%). Among the 134, only 22 (16.4%) mentioned that informed consent taken was given during the study. Studies which may have involved discrimination totaled 21 (8.4%), and the number of studies that may have violated the patients' right to privacy was 20 (8%). The number of studies that may have a conflict of interest but was not declared was 12 (4.8%). CONCLUSION: There should be greater concern about the ethical conduct of research in studies with human research subjects in the journal of the Korean Society of Emergency Medicine.
Bioethics ; Checklist ; Conflict of Interest ; Discrimination (Psychology) ; Emergencies ; Emergency Medicine ; Ethical Review ; Ethics Committees, Research ; Helsinki Declaration ; Humans ; Informed Consent ; Patient Rights ; Privacy ; Research Subjects

A 57-year-old man complained of severe lower back pain and radicular pain in both legs for 1 week after falling from a ladder. Magnetic resonance imaging (MRI) of the spine showed a subdural hematoma (SDH), which was surgically removed. The patient had no back pain or the radicular leg pain at 2 weeks post-surgery. However, he complained of diffuse headaches upon follow-up. Brain computed tomography (CT) and MRI revealed an intracranial SDH, which was immediately removed by surgery. During his 1-year follow-up, he reported that the pain had resolved without recurrence. Simultaneous spinal and intracranial SDH are rare and no standard treatment exists for this condition. This case suggests that it is possible that an intracranial SDH can migrate into the cerebrospinal fluid (CSF) space through an arachnoid tear. CSF circulation allows the intracranial SDH to enter subarachnoid spaces encasing the spinal cord. In order to prevent irreversible damage, surgical intervention should be considered for case of spinal SDH with progressive neurological deficits.
Arachnoid ; Back Pain ; Brain ; Cerebrospinal Fluid ; Follow-Up Studies ; Headache ; Hematoma, Subdural ; Hematoma, Subdural, Intracranial* ; Hematoma, Subdural, Spinal ; Humans ; Leg ; Low Back Pain ; Magnetic Resonance Imaging ; Middle Aged ; Recurrence ; Spinal Cord ; Spinal Injuries ; Spine ; Subarachnoid Space ; Subdural Space* ; Tears

PURPOSE: The purpose of this study is to evaluate the clinical results of wire fixation technique for tibial tubercle osteotomy in total knee arthroplasty. MATERIALS AND METHODS: Twenty-three cases who underwent TKA with tibial tubercle osteotomy and wire fixation technique for the extensile exposure between January, 1982 and April, 2001, were reviewed. Seventeen cases were male and six cases female. The averageperiod of follow-up was 58 months. The average age was 62.3 years (minimal: 38, maximal: 74). Five cases underwent tibial tubercleosteotomy for primary TKA and the preoperative diagnoses were degenerative osteoarthritis in 2 cases, posttraumatic osteoarthritis in 1case and rheumatoid arthritis in 2 cases. Eighteen cases underwent tibial tubercle osteotomy for revision TKA due to the infected TKAin 10 cases and aseptic loosening in 8 cases. Osteotomized tibial tubercle in size of 2x10 cm was achieved by using oscillating saw and curved osteotome from the point of 2 cm distal to the articular surface of proximal tibia to 8 cm below the tibial tubercle. Six holes were drilled with 1 cm distance for 3 wires passage. The tubercle fragment was fixed with 3 wires and the wires were bent around the tibial stemin the medullary canal for passage through tubercle fragment. The passive range of motion was started within one week after the operation. We evaluated the preoperative and postoperative range of motion and the radiologic bony union was assessed by lateral radiograph. The clinical results were assessed by Knee Society Knee Score. RESULTS: The bony union was achieved in twenty-two cases about 13 moths after the operation, and fixation loss was observed in one case. The average range of motion were 70 degrees (5-90 degrees) preoperatively and 80.8 degrees (25-110 degrees) postoperatively. The average clinical knee scores of painand function were 51 (40-57) point, 58 (45-70) point preoperatively and 54 (50-65) point, 65 (54-78) point postoperatively. Two complications were noted with one case of infection and fixation loss due to injury in each. CONCLUSION: Wire fixation for tibial tubercle osteotomy in total knee arthroplasty results in firm fixation of tubercle fragment, therefore it seems to be an useful technique in exposure for total knee arthroplasty.
Arthritis, Rheumatoid ; Arthroplasty* ; Diagnosis ; Female ; Follow-Up Studies ; Humans ; Knee* ; Male ; Moths ; Osteoarthritis ; Osteotomy* ; Range of Motion, Articular ; Tibia