Fibroelastolytic papulosis of the neck(FEPN) was introduced by Balus et al in 1997. Before this term was used, white fibrous papulosis of the neck(WFPN) and pseudoxanthoma elasticumlike papillary dermal elastolysis(PDE) had differently been used. These two disease entities had clinical similarities such as asymptomatic, white to yellow discolored, papular eruptions on the neck in elderly persons. As names implicated, however, they showed variable histological findings, for examples, fibrosis in WFPN or elastolysis in PDE or both in FEPN. Taken into ac-count together, instead of using WFPN or PDE separately, FEPN might be preferred to describe these two kinds of skin diseases. We report a case of a 36-year-old male patient with papules compatible with FEPN, whose biopsy mainly showed elastolysis.
Adult ; Aged ; Biopsy ; Fibrosis ; Humans ; Male ; Neck* ; Skin Diseases

One of the most important factors leading to a successful healing of rotator cuff tear is good bone quality to secure the suture anchor in the bone for a stable fixation. However, rotator cuff tear are commonly found in elderly patients, and their proximal humerus often shows osteoporosis or cystic lesions. Especially when the transosseous repair prevails for a torn rotator cuff, a weak metaphyseal cancellous bone is often the case, which associated with difficulty in stable fixation of the lateral row suture anchor. In this situation, we were able to augment the lateral row fixation with polymethylmethacrylate bone cement. Although there is a concern of disturbance in the blood flow and healing potential, our case showed good clinical results with respect to healing. If we suspect a weak fixation of the lateral row suture anchor, bone cement seems to be a good option for augmentation.
Aged ; Bone Cements ; Humans ; Humerus ; Osteoporosis ; Polymethyl Methacrylate ; Rotator Cuff* ; Suture Anchors ; Tears

Since the olecranon fractures are caused by relatively low-energy injuries, such as a fall from standing height, they are usually found without comminution. Less commonly they can be developed by high-energy injuries and have severe concomitant comminution or injuries to surrounding structures of the elbow. Because the fracture by nature is intra-articular with the exception of some avulsion-type fracture, a majority of olecranon fractures are usually indicated for surgical treatment. Even if there is minimal displacement, surgical treatment is recommended because there is a possibility of further displacement by the traction force of triceps tendon. The most common type of olecranon fracture is displaced, simple non-comminuted fracture (that is, Mayo type IIA fractures). Although tension band wiring was the most widespread treatment method for these fractures previously, there is some trends toward fixation using locking plates. Primary goal of the surgery is to restore a congruent joint and extensor mechanisms by accurate reduction and stable fixation so that range of motion exercises can be performed. The literature has shown that good clinical outcomes are achieved irrespective of surgical fixation technique. However, since the soft tissue envelope around the elbow is poor and the implants are located at the subcutaneous layer, implant irritation is still the most common complication associated with surgical treatment.
Elbow ; Exercise ; Fracture Fixation ; Joints ; Methods ; Olecranon Process* ; Range of Motion, Articular ; Tendons ; Traction

Rud's syndrome (RS), basically composed of ichthyosis, mental deficiency and hypogonadism, is a rare hereditary disease. Some varying dermatologic, neurologic, endocrinologic, ophthalmologic and musculoskeletal abnormalities have coincided with RS. No case of RS has been documented from Asian countries except one from Japan. We describe a 16-year-old girl who presented with lamellar ichthyosis, mental retardation, hypogonadism, short stature, alopecia, sparse eyebrows, strabismus, cataracts, and congenital dislocation of the hip. To our knowledge, RS coexisting congenital dislocation of the hip herein is the first case in English literature.
Adolescent ; Alopecia ; Asian Continental Ancestry Group ; Cataract ; Dislocations ; Eyebrows ; Female ; Genetic Diseases, Inborn ; Hip ; Humans ; Hypogonadism ; Ichthyosis ; Ichthyosis, Lamellar ; Intellectual Disability ; Japan ; Musculoskeletal Abnormalities ; Strabismus

Mammary carcinoma was induced in rats by itravenous injection of N-methy-N-Nitrosourea. Microangiography was perfromed to evaluate the microvascular alterations in mammary carcinoma after irradiation. The tumors were givena single dose of 1.400 rads using Co-60 telethrapy unit with field size of 4 x 4 cm at 40 cm SSD. The dose ratewas 147.5 rads per minute. Microangiography was performed prior to irradiation and at one, two, and four weeksfollowing irradiation. The results are as follows: 1. Before irradiation, mammary carcinoma in rats tended to formlobules and the basic vasculature consisted of peripheral vascular pattern with central penetrating vessels. Theperipheral vascular pattern was always richer than that of the center. Irregular and tortuous vessles stretchedfrom the periphery into the center of lobule. 2. One week following irradiation, an increase in the number ofsmaller, tortuous vessels and decreased intervasular distance were obseved in the central portion of each lobule.This finding seems to be due to an improved filling of some previously existing but unfilled vessels. This maylead to improved metabolic changes and reoxygenation. 3. Later's changes of microvasculature after irradiation aretortuosity, irregularity, narrowing, abrupt tapering, fragmentation, and extravasation. These findings progressedafter a lapse of time. 4. The results can be considered as the microangiographic demonstration of the fact that reoxygenation after irradiation is mainly due to dilatation of the collapsed tumor vessels.
Animals ; Dilatation ; Microvessels ; Radiation Effects ; Rats ; Silver Sulfadiazine

No abstract available.
Adult ; Humans

One of the most important factors leading to a successful healing of rotator cuff tear is good bone quality to secure the suture anchor in the bone for a stable fixation. However, rotator cuff tear are commonly found in elderly patients, and their proximal humerus often shows osteoporosis or cystic lesions. Especially when the transosseous repair prevails for a torn rotator cuff, a weak metaphyseal cancellous bone is often the case, which associated with difficulty in stable fixation of the lateral row suture anchor. In this situation, we were able to augment the lateral row fixation with polymethylmethacrylate bone cement. Although there is a concern of disturbance in the blood flow and healing potential, our case showed good clinical results with respect to healing. If we suspect a weak fixation of the lateral row suture anchor, bone cement seems to be a good option for augmentation.
Aged ; Bone Cements ; Humans ; Humerus ; Osteoporosis ; Polymethyl Methacrylate ; Rotator Cuff ; Suture Anchors ; Tears

No abstract available.
Dermatitis, Allergic Contact

BACKGROUND: The purpose of this study was to evaluate the angle between the long head of the biceps tendon (LHBT) and the glenoid during arthroscopic surgery and its correlation with biceps subluxation on magnetic resonance imaging (MRI). Furthermore, we evaluated the relationship of this angle with subscapularis tears and biceps pathologies. METHODS: MRI and arthroscopic images of 270 consecutive patients who had undergone arthroscopic surgery were retrospectively evaluated. On MRI, 60 shoulders with biceps subluxation and 210 shoulders without subluxation were identified. On the arthroscopic view from the posterior portal, the angle between the LHBT and the glenoid (biceps-glenoid angle) was measured. The biceps-glenoid angle, tears of the LHBT, degenerative superior labrum anterior to posterior (SLAP) lesions, and presence of a subscapularis tear were compared according to the presence of biceps subluxation on MRI. RESULTS: In the subluxation group, 51 (85%) had a subscapularis tendon tear and all shoulders showed biceps tendon pathologies. In the non-subluxation group, 116 (55.2%) had a subscapularis tendon tear, 125 (60%) had tears in the biceps tendon, and 191 (91%) had degenerative SLAP lesions. The incidences of subscapularis tears (p < 0.001) and biceps pathologies (p < 0.001) showed significant differences. The mean biceps-glenoid angle was 87.0° (standard deviation [SD], 11.4°) in the subluxation group and 90.0° (SD, 9.6°) in the non-subluxation group, showing a statistically significant difference (p = 0.037). CONCLUSIONS: Shoulders with subluxation of the biceps tendon on the preoperative MRI revealed more pathologies in the subscapularis tendon and biceps tendon during arthroscopy. However, the arthroscopically measured biceps-glenoid angle did not have clinical relevance to the determination of subluxation of the LHBT from the bicipital groove.
Arthroscopy ; Head* ; Humans ; Incidence ; Magnetic Resonance Imaging ; Pathology ; Retrospective Studies ; Shoulder ; Tears* ; Tendons*

The natural course of lateral epicondylitis is widely regarded to be self-limiting within 1 year of symptom duration in 90% of all patients. The spectrum of treatments include simple ‘wait and see', bracing, physical therapy, corticosteroid injection, and recently some biologic injection such as autologous blood and platelet rich plasma. However, recalcitrant lateral epicondylitis which are not responding to conservative treatments can be treated with surgical treatment although much remains unclear regarding the ideal treatment. Debates surrounding open procedures are the management for the defect after resection of pathologic tissue, necessity of decortication, selective denervation procedure, etc. Since the trend is changing to minimal invasive surgery and arthroscopic release of extensor carpi radialis brevis tendon are becoming more popular these days, surgical tips and pitfall to obtain good results and avoid complications have been reported recently. Bipolar radiofrequency (RF)-based microtenotomy or percutaneous tendon release is another surgical procedures reported to be effective in lateral epicondylitis. However, there are some patients who present with persistent pain after surgical treatment. Thus, selection of ideal candidates for surgery, thorough evaluation of all pathologies prior to surgery, and adequate surgical procedures would be essential in the surgical treatment of lateral epicondylitis.
Braces ; Denervation ; Humans ; Pathology ; Platelet-Rich Plasma ; Tendons ; Tennis Elbow ; Tenotomy