The giant intra-articular osteochondroma of the knee is very rare and is probably result of synovial metaplasia of the fibrous capsule or of the adjacent connencive tissue of a joint, and of the fragment of articular cartilage. The gross findings and histology are consistent with the osteochondroma. The authors experienced a case of giant intra-articular osteochondroma of the right knee in a 19 years old man who had history of knee injury when he was 16 years old. The mass was excised and the symptome was relieved.
Cartilage, Articular ; Joints ; Knee Injuries ; Knee ; Metaplasia ; Osteochondroma

No abstract available.
Lymphoma*

No abstract available.
Sinusitis*

Aging changes on the upper third of the face include brow ptosis, glabellar furrowing and forehead transverse wrinkle caused by an imbalance of the forehead muscles. Surgical methods to correct these phenomena include forehead lift with a coronal incision, endoscopic access, and direct forehead skin excision. In response to a common need for cosmetic improvement in the brow-upper eyelid and a desire for minimal incisions for forehead rejuvenation, an approach through blepharoplasty incision had been developed. This approach has many advantages, such as fewer skin incision, less tissue mobilization and direct excision of the hyperactive depressor muscles. However, this approach is not suitable for those who have significant forehead wrinkle and ptosis. We used a combined subperiosteal approach for forehead lift and transection of the hyperactive corrugator and procerus muscles through blepharoplasty incision. This combined surgical technique is simple and effective to correct aging of the upper third of the face without the usual complication. We performed 10 cases of the transpalpebral approach for the correction of the upper third of the face from January 1997 to September 1998, following them up for from 3 to 6 months and obtained satisfactory results. We report our experiences with a review of the literature.
Aging* ; Blepharoplasty ; Eyelids ; Forehead ; Muscles ; Rejuvenation ; Skin

Fournier described five patients with gangrene of male external genitalia in 1883 and emphasized three characteristics: (1) abrupt onset in young healthy male, (2) rapid progression to gangrene,(3) absence of discernible cause. But more recent reports described genital gangrene as occurring in any age group and 4 patients in our cases, the mean age was 46 years with an age range of 31 to 59 years. Predisposing causes were as follows: case 1. prostatic calculi, Buerger's disease, case 2, perianal abscess, case 3, diabetes mellitus, case 4, tuberculous spondylitis accompanied by paraplegia and bed sores, liver cirrhosis. The duration of symptoms prior to the development of gangrene varied between 4 to 10 days. The cultured organisms were as follows : case 1. Alpha-hemolytic streptococcus, case 2. E. coli, Alpha-hemolytic streptococcus case 3. Alpha-hemolytic streptococcus, case 4, Mycobacterium tuberculosis, proteus species. Reconstructive surgery of defected scrotum was performed postoperative 8 to 41 days (mean 28.7) and total admission period was 25 to 83 days (mean 46 days).
Abscess ; Calculi ; Diabetes Mellitus ; Fournier Gangrene* ; Gangrene ; Genitalia ; Humans ; Liver Cirrhosis ; Male ; Mycobacterium tuberculosis ; Paraplegia ; Pressure Ulcer ; Proteus ; Scrotum ; Spondylitis ; Streptococcus ; Thromboangiitis Obliterans

No abstract available.
Melanoma ; Nevus

Eleven patients with advanced prostatic cancer who had received single agent chemotherapy with cyclophosphamide were evaluated. All patients had pathologically confirmed prostatic adenocarcinoma and were unresponsive to or in relapse after hormonal therapy. They were treated intravenously with 200mg/m2 cyclophosphamide daily for four days every four weeks. The National prostatic Cancer Project(NPCP) response criteria were used. so objective response included patients with complete or partial response as well as objectively stable disease as defined by NPCP response criteria. The response rate was 54.6 %. with three partial response(27.3 8 ) and three objectively stable disease(27.3) of the eleven patients. All the six patients with partial response and objectively stable disease lived longer than 4 year, whereas for the five patients with objective progression. only two patient lived longer than 1 year. Toxicity was mild and tolerable. Mild and asymptomatic cyclophosphamide-induced hyponatremia was observed in two patients and hemorrhagic cystitis of mild degree was observed in one patient Severe hematologic and gastrointestinal toxicities were not observed.
Adenocarcinoma ; Cyclophosphamide* ; Cystitis ; Drug Therapy* ; Humans ; Hyponatremia ; Prostatic Neoplasms* ; Recurrence

Infectious complications such as wound infection and intra-abdominal abscess are rarely fatal, but perplexing to both patients and surgeons, and still remain asserious problem after appendectomy in about 5% of the patients. To be helpful to reduce post-appendectomy complications, authors retrospectively analyzed 229 cases of appendectomy performed during the period of one year, from January 1 through December 31, 1995, to find out contributing factors to the post-appendectomy infectious complications such as wound infection or intra-abdominal abscess. The results were as follows. 1) Infectious complications are more common in patients with four or more days of symptom. 2) Infectious complications are more common in patients with complicated appendicitis such as gangrenous or perforated appendicitis. 3) Preoperative antibiotics are helpful to prevent infectious complications in cases of complicated appendicitis. 4) There is no difference in the incidence of infectious complications between the immediate operations and overnight delayed operations in patients who were admitted in the late evening or at night. 5) There is no difference in the incidence of infectious complications between operators: staff surgeons who exclusively operated on patients with complicated appendicitis and residents(with or without supervision of staff surgeons) who mostly operated on patients with simple appendicitis. This means technical superiority has its role in preventing infectious complications. Early diagnosis and operation before the gangrenous change or perforation are warranted. Preoperative antibiotics are effective in cases of complicated appendicitis, but not in cases of simple appendicitis. But the lack of objective criteria to decide complicated appendicitis before the operation remains problem, and prospective study to solve this problem is needed. Technical perfectness is required to protect the wound and to remove the appendix without contamination. Preventive measures are also important to prevent the infectious complications in cases of inevitably contaminated wounds or inta-abdominal spaces.
Abdominal Abscess ; Anti-Bacterial Agents ; Appendectomy ; Appendicitis ; Appendix ; Early Diagnosis ; Humans ; Incidence ; Organization and Administration ; Retrospective Studies ; Wound Infection ; Wounds and Injuries

Meigs' syndrome is defined as a hydrothorax with ascites and a pelvic tumor, both of which resolve on removal of the tumor. Pseudo-Meigs' syndrome is a variant not possessing the original tumor cell types described by Meigs. Both these syndromes should be considered in otherwise healthy women who present with either new or recurrent hydrothorax and ascites. Pseudo-Meigs' syndrome occurs with the clinical triad of (1)ascites, (2)pleural effusion and (3)Brenner tumors, struma ovarii, benign thecomas, extreme ovarian edema, uterine leiomyomas or other benign pelvic tumors. A case of Pseudo-Meigs' syndrome associated with Brenner tumor is presented with a brief review of literatures.
Ascites ; Brenner Tumor ; Edema ; Female ; Humans ; Hydrothorax ; Leiomyoma ; Meigs Syndrome ; Struma Ovarii ; Thecoma

BACKGROUND AND OBJECTIVES: Dual isotope myocardial SPECT, rest thallium-201/dipyridamole stress Tc-99m sestamibi is used to diagnose coronary artery disease. We examined predictive value of myocardial SPECT for the prognosis of patients having or suspected coronary artery disease. MATERIALS AND METHOD: We examined 692 patients referred for dipyridamole stress myocardial perfusion SPECT. Cardiac events (hard and soft events) were followed up with medical record review and telephone interview. Survival analysis and multivariate Cox proportional hazard model were used to find significant predictors and the incremental predictive value of myocardial SPECT. Patients with coronary angiography (n=246) were analyzed in separate group. RESULTS: There were 4 hard events and 3 soft events in 341 normal SPECT group (1.20%/yr). There were 5 hard events and 21 soft events in 351 abnormal SPECT group (4.69%/yr). Survival curve was separated between normal SPECT group and abnormal SPECT group (p<0.01). In univariate analysis, smoking, history of myocardial infarction, typical chest pain and SPECT findings were important variables. In multivariate analysis, SPECT result was the single most independent predictor. Large reversible perfusion abnormality predicted worse prognosis. In patients with coronary angiography, SPECT did not add statistically significant predictive value to the coronary angiography. CONCLUSION: Dipyridamole stress Tl-201/ MIBI dual isotope myocardial perfusion SPECT provided excellent prognostic information. Extent of reversible perfusion decrease was the independent predictor of future cardiac events.
Chest Pain ; Coronary Angiography ; Coronary Artery Disease ; Dipyridamole ; Humans ; Interviews as Topic ; Medical Records ; Multivariate Analysis ; Myocardial Infarction ; Perfusion ; Prognosis ; Proportional Hazards Models ; Smoke ; Smoking ; Tomography, Emission-Computed, Single-Photon*