In 1868 Charcot described the join in tabes dorsalis, which since then has been designated as Charcot neuroarthropathy. It is characterized by painless swelling and abnormal mobility of the affected joint. Arthropathy of the type described by Charcot has been associated with various other conditions, such as diabetes mellitus, syringomyelia, injury to nerve root, congenital indfference to pain, leprosy, and intra-articular use of steroid, etc. Authors present a case of Charcot joint which involved the left knee joint associated with pathologic fracture of the left tibia and fibula.
Arthropathy, Neurogenic ; Diabetes Mellitus ; Fibula ; Fractures, Spontaneous ; Joints ; Knee Joint ; Knee ; Leprosy ; Syringomyelia ; Tabes Dorsalis ; Tibia

No abstract available.
Macrophages* ; Mistletoe* ; Tumor Necrosis Factor-alpha*

Vasectomy is one of the most common forms of male contraception throughout the world. However, more vasectomy reversals are sought each year because of the increasing number of second marriages and other causes. Before recommending vasectomy, urologists may wish to resolve in their own mind the conflict between reports that maintain the testis is harmed by vasectomy and those that slate is not. We studied a group of patients undergoing vasectomy reversal to determine whether histopathologic change on light and electron microscopy would be detected. Only one testis specimen from post-vasectomy patients showed an abnormality correlated with spermatogenesis and five cases showed mild focal interstitial fibrosis without abnormality of spermatogenesis on light and electron microscopy. We found that vasectomy has some influence to the spermatogenesis and pathologic change.
Contraception ; Fibrosis ; Humans* ; Marriage ; Microscopy, Electron ; Spermatogenesis ; Testis* ; Vasectomy* ; Vasovasostomy

A clinical observation was made on 64 cases of the bladder rupture who were admitted to our hospital during the period from June, 1979 to February, 1991. The results are as following ; 1. Of 355 cases of the genitourinary tract injury, the bladder rupture were 64 cases (18.0%), which were composed of 40 cases (62.5%) of bladder rupture without pelvic bone fracture and 24 cases (37.5%) of bladder rupture with pelvic bone fracture. The bladder rupture without pelvic bone fracture were composed of 35 cases (87.5%) with intraperitoneal bladder rupture and 5 cases (12.5%) with extraperitoneal bladder rupture, the bladder rupture with pelvic bone fracture were composed of 13 cases (12.5%) with intra and extraperitoneal bladder rupture. 2. In 24 patients with pelvic bone fracture, the most common site of bladder ruptures were found on the lateral wall in 12 cases (50%), and followed by the dome in 9 cases (37.5%), multiple areas in 3 cases (12.5%). In 40 patients without pelvic bone fracture, the most common site of bladder ruptures were found on the dome in 33 cases (82.5%), and followed by the multiple areas in 4 cases (10%), lateral wall in 3 cases (7.5%). 3. The average size of the bladder rupture was 6.5cm in cases without pelvic bone fracture, 6. 8cm in cases with pelvic bone fracture, especially comminuted pelvic ring fracture had most severed bladder rupture (average; 8.3cm). 4. Of 24 pelvic bone fractures, pubic rami fractures were most common (41.6%), and followed by comminuted pelvic ring fracture (25%), anterior and posterior pelvic ring fractures (12.5%), acetabulum and isolated fractures (8.3%), symphyseal separation fractures (4.1%) in order of frequency. 5. 5 cases (20%) of pelvic bone fractures were associated with posterior urethral injury, especially 60% in The pubic rami fracture. There was no significant relation between the type of pelvic fracture and the type of bladder rupture, but the fractures involving pubic arch were more often associated with posterior urethral injury.
Acetabulum ; Humans ; Pelvic Bones* ; Rupture* ; Urinary Bladder*

A clinical evaluation was made on 19 patients with urethral stricture following urethral catheterization in 155 urethral stricture patients during 12 years from January. 1979 to December. 1990. The following results were obtained. I. In 155 cases of urethral stricture, iatrogenic urethral stricture was 24 cases (15.4%) of which the most common cause was urethral catheterization(19 cases) and followed by instrumentation (2 cases). 2. In 19 cases of urethral stricture following urethral catheterization. the most common site was the anterior urethra (bulbous 10 cases. pendulous 7 cases) and multiple strictures showed 5 of 17 anterior urethral strictures. 3. In 19 cases, 16 cases (84.2%) occurred in patients who have kept the urethral catheter within seven days and 18 cases (94.7%) were inserted and cared the urethral catheter by non-urologist. 4. Treatment was performed internal urethrotomy in 16, dilatation in 2 and catheter indwelling during 1 week in 1. 5. In 24 cases of iatrogenic urethral stricture. mean number of dilation to recurrent strictures after primary procedure had required O.5 time. From our results. we suggest that education for the careful insertion and method of care for the urethral catheter to non-urologist is least likely to induce urethral stricture formation.
Catheters ; Constriction, Pathologic ; Dilatation ; Education ; Humans ; Urethra ; Urethral Stricture* ; Urinary Catheterization* ; Urinary Catheters*

Morgagni hernia is an uncommon presentation representing about 3% in incidene and usually located in the right-sided anterior diaphragm. We experienced a case of Morgagni hernia in a seventy four-year-old male who was admitted complaining of intermittent abdominal pain. The diagnosis was made initially by chest and abdominal radiography, and an incarcerated Morgagni hernia was finally diagnosed with abdominal CT scans. Emergent laparotomy was performed. Morgagni foramen was located on the left-sided anterior diaphragm and Morgagni hernia which contained greater omentum and strangulated small intestine was gently reducted. Morgagni foramen measuring 4x5 cm was repaired with a Gortex mesh. We reported the experience of left-sided Morgagni hernia complicating incarcerated small bowel hernia in an old male patient.
Aged ; Hernia, Diaphragmatic/diagnosis/etiology/*radiography ; Humans ; Intestinal Obstruction/complications/*diagnosis ; *Intestine, Small ; Male ; Tomography, X-Ray Computed

Objectives: . Multiple minimally invasive techniques for chronic rhinitis treatment focus on posterior nasal nerve ablation. We conducted a systematic review and meta-analysis to evaluate the efficacy of cryotherapy and radiofrequency ablation for alleviating symptoms in patients with allergic and nonallergic rhinitis. Methods: . We retrieved studies from PubMed, Scopus, Embase, Web of Science, and Cochrane Database up to July 2023. Data on the impact of cryotherapy and radiofrequency ablation on quality of life and symptom ratings of rhinitis were extracted and evaluated. Results: . An analysis of 12 studies involving 788 patients demonstrated significant improvements in quality of life and rhinitis-related symptoms (nasal obstruction, itching, rhinorrhea, and sneezing) in patients treated with cryotherapy or radiofrequency ablation (symptom score at 24 months and quality of life score at 3 months). However, radiofrequency ablation had a more positive effect on nasal symptoms after 3 months than cryotherapy. Nonallergic rhinitis patients responded more favorably to posterior nerve ablation than patients with allergic rhinitis. Both techniques enhanced disease-specific quality of life during the initial 3 months of treatment (cryotherapy, 84.6%; radiofrequency, 81.6%; P=0.564). After 3 months of treatment, a clinical improvement in all nasal symptoms (minimal clinically important difference in the total nasal symptom score: >1.0 points) was seen in 81.8% and 91.9% of patients who underwent cryotherapy and radiofrequency ablation, respectively (P=0.005), suggesting that radiofrequency is more likely to lead to clinical improvement. Conclusion . Rhinitis-associated subjective symptom scores and quality of life may be improved by both cryotherapy and radiofrequency ablation. Ablation was more efficacious than cryotherapy for nasal symptoms in patients with nonallergic rhinitis. To corroborate these findings, further randomized controlled studies directly comparing these two techniques are warranted.

PURPOSE: Proliferative vitreoretinopathy (PVR) is a major cause of recurrence and failure after retinal reattachment surgery. We assessed the effect and safety of adjuvant combination therapy using 5-Fluorouracil (5-FU) and low molecular weight heparin (LMWH) for prevention of PVR after vitrectomy. METHODS: Infusion fluid supplemented with 200 micro gram/mln of 5-FU and 5 IU/ml of LMWH was used during vitrectomy for rhegmatogenous retinal detachment in 21 patients with PVR. Anatomical results, the occurrence of postoperative PVR, and best corrected visual acuity were assessed retrospectively after a minimum of 6-month follow-up. The occurrence of complication was investigated in 27 eyes including an additional 6 eyes without PVR. RESULTS: The primary success rate was 85.7% (18/21) and the incidence of postoperative PVR was 14.3% (3/21). There was hyphema or vitreous hemorrhage in 3 eyes (14.3%), and significant corneal edema in 1 eye (4.8%) immediately after operation. Those complications were resolved without surgical management. There was intraocular pressure elevation (47.6%), and progression of cataract (23.8%) after operation. Those were controlled with antiglaucoma medication or operation. CONCLUSIONS: The use of 5-FU and LMWH is relatively safe and is suggested to have an antiproliferative effect.
Cataract ; Corneal Edema ; Fluorouracil* ; Follow-Up Studies ; Heparin* ; Heparin, Low-Molecular-Weight ; Humans ; Hyphema ; Incidence ; Intraocular Pressure ; Recurrence ; Retinal Detachment ; Retinaldehyde ; Retrospective Studies ; Visual Acuity ; Vitrectomy ; Vitreoretinopathy, Proliferative* ; Vitreous Hemorrhage

PURPOSE: Retinal detachment due to macular holes in highly myopic eyes is now usually treated by intraocular gas tamponade with pars plana vitrectomy. However, reopening of the macular holes occurs frequently. In this study, we performed macular buckling for recurred retinal detachment caused by macular holes in highly myopic eyes that failed with vitrectomy and intraocular gas tamponade. We observed that these complex cases could be successfully repaired with this procedure. METHODS: Retinal detachment resulting from a macular holes was found to be present in 3 highly myopic eyes. Retinal reattachment was obtained in all eyes following pars plana vitrectomy and removal of the internal limiting membrane in the posterior pole and fluid-gas exchange. A few months later, the retinal redetachment occurred as a result of reopened macular hole. We performed macular buckling as reoperation. RESULTS: After the second surgery, the macular hole remained closed and the retina remained reattached in all 3 eyes. Retinal reattachment was maintained for longer than 3 months of follow-up periods, and the final visual acuity was improved. CONCLUSIONS: This small case series suggest that macular buckling is an effective procedure of reoperation for failed initial vitrectomy for retinal detachment with macular holes in highly myopic eyes.
Follow-Up Studies ; Membranes ; Reoperation ; Retina ; Retinal Detachment* ; Retinal Perforations* ; Retinaldehyde* ; Visual Acuity ; Vitrectomy

The pencil beam convolution (PBC) algorithms in radiation treatment planning system have been widely used to calculate the radiation dose. A new photon dose calculation algorithm, referred to as the anisotropic analytical algorithm (AAA), was released for use by the Varian medical system. The aim of this paper was to investigate the difference in dose calculation between the AAA and PBC algorithm using the intensity modulated radiation therapy (IMRT) plan for lung cancer cases that were inhomogeneous in the low density. We quantitatively analyzed the differences in dose using the eclipse planning system (Varian Medical System, Palo Alto, CA) and I'mRT matirxx (IBA, Schwarzenbruck, Germany) equipment to compare the gamma evaluation. 11 patients with lung cancer at various sites were used in this study. We also used the TLD-100 (LiF) to measure the differences in dose between the calculated dose and measured dose in the Alderson Rando phantom. The maximum, mean, minimum dose for the normal tissue did not change significantly. But the volume of the PTV covered by the 95% isodose curve was decreased by 6% in the lung due to the difference in the algorithms. The difference dose between the calculated dose by the PBC algorithms and AAA algorithms and the measured dose with TLD-100 (LiF) in the Alderson Rando phantom was -4.6% and -2.7% respectively. Based on the results of this study, the treatment plan calculated using the AAA algorithms is more accurate in lung sites with a low density when compared to the treatment plan calculated using the PBC algorithms.
Humans ; Lung ; Lung Neoplasms