Osteochondritis dissecans of the knee occurs twice as often in males as in females. The peak incidence is about fifteen years of age, and most patients are first diagnosed before the age of eighteen. The etiology of osteochondritis dissecans is still unknown, but the most accepted theories are trauma, ischemia, abnormal ossification within the physes, constitutional or genetic predisposition, and a combination of these. Osteochondritis dissecans of the knee associated with gout was first reported by Carrabba in 1969. And no additional case has been reported. The purpose of this paper is to present an unusual case of osteochondritis dissecans of the knee associated with gout.
Female ; Genetic Predisposition to Disease ; Gout* ; Humans ; Incidence ; Ischemia ; Knee* ; Male ; Osteochondritis Dissecans* ; Osteochondritis*

Bone single photon emission computed tomography(SPECT) of the knees has been shown to be of diagnostic value for the investigation of intemal derangement of knees(IDK). This study compared bone SPECT and magnetic resonance image(MRI) with arthroscopic findings for the diagnosis of IDK. Fifty patients who had been performed arthroscopy in Seoul National University Hospital from January 1997 to September 1997 were studied with both the modalities preoperatively. There were 38 meniscal injuries, 26 cruciate ligament injuries and 8 cases of patellofemoral joint problems. In view of SPECT, the most remarkable results were from meniscal tears. In meniscal tears, the diagnostic values of SPECT were 89.5% of sensitivity, 66.7% of specificity, 84% of diagnostic accuracy, which were comparable to those of MRI, 97.4%, 91.7% and 96%, respectively. But SPECT showed inferior diagnostic values in cruciate ligament injuries. For anterior knee pain, SPECT was more sensitive than MRI for the detection of pathology. And for functionally related cases, such as ACL impingement to intercondylar notch, SPECT was far more valuable than MRI. Bone SPECT will not provide the anatomical detail of MRI but seems to be a useful tool for the detection of wide range of knee disorders including IDK. Further research is justified to investigate the precise role of bone SPECT in clinical practice and its value in relation to MRI.
Arthroscopy ; Diagnosis ; Humans ; Knee* ; Ligaments ; Magnetic Resonance Imaging* ; Patellofemoral Joint ; Pathology ; Sensitivity and Specificity ; Seoul ; Tomography, Emission-Computed, Single-Photon*

BACKGROUND: Keloids are benign fibro-proliferative lesion, related to excessive inflammatory reactions in certain anatomical areas, including the auricles. Their specific etiology remains unclear; nonetheless they exhibit tumor-like characteristics of significant recurrence and cause emotional distress, even with various treatment strategies. We applied intermittent magnetic pressure therapy on ear keloids in combination with surgical excision, and present its effectiveness herein.METHODS: Ear keloid patients were treated with surgical excision followed by magnetic pressure therapy. The keloid tissues underwent excision and keloid marginal flaps were utilized for wound closure. Intermittent magnetic pressure therapy was applied 2 weeks after the surgical procedure. The pressure therapy consisted of a 3-hour application and 2-hour resting protocol (9 hr/day), and lasted for 6 months. The results were analyzed 6 months after the therapeutic procedures, using the scar assessment scale.RESULTS: Twenty-two ear keloids from 20 patients were finally reviewed. Among the keloids that completed the therapeutic course, 20 ear keloids out of 22 in total (90.9%) were successfully eradicated. Two patients (2 keloids) exhibited slight under-correction. Postoperative complications such as wound dehiscence or surgical site infection were not noted. The scar assessment scale demonstrated a significant improvement in each index. The intermittent pressure therapy led to patient compliance, and avoided pressure-related pain and discomfort.CONCLUSION: Excision followed by intermittent pressure application using a magnet successfully reduced the burden of fibro-proliferative keloids, and had good patient compliance. The role of intermittent pressure application and resting should be studied with regard to keloid tissue remodeling.
Cicatrix ; Ear ; Humans ; Keloid ; Patient Compliance ; Postoperative Complications ; Recurrence ; Surgical Wound Infection ; Treatment Outcome ; Wounds and Injuries

The scalp is the thickest skin in the body and protects the intracranial structures. The coverage of a large scalp defect is a difficult surgical procedure, the full details of which must be considered prior to the procedure, such as defect size and depth, and various factors related to the patient’s general condition. Although a free flap is the recommended surgical procedure to cover large scalp defects, it is a high-risk operation that is not appropriate for all patients. As such, other surgical options must be explored. We present the case of a patient with an ulcer on the scalp after wide excision and split-thickness skin graft for squamous cell cancer. We successfully performed a reverse temporalis muscle flap for this patient.

Juvenile psammomatoid ossifying fibroma (JPOF) is a rare, benign, fibro-osseous variant of ossifying fibroma. It exhibits short-term rapid growth and has a high recurrence rate. Herein we describe a case of JPOF of the maxilla that was treated via complete excision utilizing an intraoral approach with immediate reconstruction using an iliac bone graft, in conjunction with a comprehensive review of the literature. A 20-year-old man presented with a mass on his right cheek that he reported had been growing over the last 10 months. In that cheek he had noticed fullness and experienced pressure, tenderness, and fluffiness, with no other ophthalmic or dental symptoms. After clinical, radiological, and histological examinations, the diagnosis was confirmed as JPOF. Surgical excision was performed, followed by immediate reconstruction with an autologous iliac cortical and cancellous bone graft harvested from the right iliac crest under general anesthesia. Good cicatrization of the intraoral surgical wounds and right iliac crest were evident. He was monitored for 6 months after the surgery and exhibited appropriate midfacial contour. There were no signs of recurrence or complications.

Right atrial aneurysm is an extremity rare congenital heart defect. We report a case which was diagnosed during the early fetal stage and operated on in a 2 week old neonate. Following median sternotomy, aneurysmectomy was performed under a cardiopulmonary bypass. Histopathological examination of the resected atiral tissue showed a lipotomatous degeneration and reduction of the muscular elements. There were no postoperative complications.
Aneurysm ; Cardiopulmonary Bypass ; Extremities ; Heart Aneurysm ; Heart Atria ; Heart Defects, Congenital ; Humans ; Infant, Newborn ; Postoperative Complications ; Sternotomy

BACKGROUND: This study was conducted to determine the relationship between third molar (M3) and mandibular fracture.METHODS: Patients with unilateral mandibular angle or condyle fractures between 2008 and 2018 were evaluated retrospectively. Medical records were reviewed regarding the location of fractures, and panoramic radiographs were reviewed to discern the presence and position of ipsilateral mandibular third molars (M3). We measured the bony area of the mandibular angle (area A) and the bony area occupied by the M3 (area B) to calculate the true mandibular angle bony area ratio (area A–B/area A× 100).RESULTS: The study consisted of 129 patients, of which 60 (46.5%) had angle fractures and 69 (53.5%) had condyle fractures. The risk of angle fracture was higher in the presence of M3 (odds ratio [OR], 2.2; p< 0.05) and the risk of condyle fracture was lower in the presence of M3 (OR, 0.45; p< 0.05), than in the absence of M3. The risk of angle fracture was higher in the presence of an impacted M3 (OR, 0.3; p< 0.001) and the risk of condyle fracture was lower in the presence of an impacted M3 (OR, 3.32; p< 0.001), than in the presence of a fully erupted M3. True mandibular angle bony area ratio was significantly lower in the angle fractures than in the condyle fractures (p= 0.003).CONCLUSION: Angle fractures had significantly lower true mandibular angle bony area ratios than condyle fractures. True mandibular angle bony area ratio, a simple and inexpensive method, could be an option to predict the mandibular fracture patterns.
Humans ; Mandible ; Mandibular Fractures ; Medical Records ; Methods ; Molar, Third ; Retrospective Studies ; Tooth, Impacted

Pestalotiopsis species are filamentous fungi that are known plant pathogens commonly isolated in tropical and subtropical regions. To the best of our knowledge, this is the first case of human infection caused by Pestalotiopsis mangiferae. An 80-year-old male farmer presented with ocular pain in the right eye. At initial presentation, slit-lamp examination showed a 3.0×2.5 mm-sized epithelial defect in the cornea of the right eye accompanied by corneal thinning. A KOH examination revealed spores, and consequently, treatment with voriconazole, ceftazidime, and moxifloxacin was initiated. One month later, a second KOH examination and fungal culture were performed. The results of the KOH examination indicated the presence of many hyphae, and fungus was isolated from the culture. Molecular identification revealed that the sequence had 100% similarity to P. mangiferae. The patient was treated with therapeutic penetrating keratoplasty. During follow-up in the outpatient clinic, signs of infection were not observed.

Primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder is a rare disease characterized by a single mass on the face or upper part of the trunk. It usually presents an asymptomatic and favorable progression, and its histopathologic findings include small and medium-sized lymphoid cells. The authors report a case of primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder on the forehead. A 51-year-old man presented with a protruding mass on his forehead that the patient had noted 1 month previously. Surgical excision and a permanent biopsy were performed under local anesthesia. Based on the biopsy results, the mass was diagnosed as a primary cutaneous CD4+ small/medium T-cell lymphoproliferative disorder. There was no evidence of recurrence at a 15-month follow-up visit.

Background: Hand fractures can be treated using various operative or nonoperative methods. When an operative technique utilizing fixation is performed, early postoperative mobilization has been advocated. We implemented a protocol involving controlled active exercise in the early postoperative period and analyzed the outcomes. Methods: Patients who were diagnosed with proximal phalangeal or metacarpal fractures of the second to fifth digits were included (n=37). Minimally invasive open reduction and internal fixation procedures were performed. At 3 weeks postoperatively, controlled active exercise was initiated, with stress applied against the direction of axial loading. The exercise involved pain-free active traction in three positions (supination, neutral, and pronation) between 3 and 5 weeks postoperatively. Postoperative radiographs and range of motion (ROM) in the interphalangeal and metacarpophalangeal joints were analyzed. Results: Significant improvements in ROM were found between 6 and 12 weeks for both proximal phalangeal and metacarpal fractures (P<0.05). At 12 weeks, 26 patients achieved a total ROM of more than 230° in the affected finger. Postoperative radiographic images demonstrated union of the affected proximal phalangeal and metacarpal bones at a 20-week postoperative follow-up. Conclusions Minimally invasive open reduction and internal fixation minimized periosteal and peritendinous dissection in hand fractures. Controlled active exercise utilizing pain-free active traction in three different positions resulted in early functional exercise with an acceptable ROM.