We report herein a 53-year-old male patient with a large condyloma acuminaturn of 16 months duration on his penis. Clinically, an approximat;ely 3.5 X 2.0 Cm sized, asyrnptomatic, verrucous-surfaced, papilloma was present on his prepuce and glans. Elistological examination disclosed hyperkeratosis, marked acanthosis, papillomatosis, vacuolated upper malphigian cells, dilated capillaries, and mononuclear infiltrntes in the upper dermis. Trial of DNCB immunotherapy showed a dramatic effect on tumor regression.
Capillaries ; Dermis ; Dinitrochlorobenzene* ; Humans ; Immunotherapy ; Male ; Middle Aged ; Papilloma ; Penis

We report herein a case of tuberculosis cutis orificialis in a 50-year-old man. He suffered from well demarcated, 2x5cm sized, slightly tender, pus discharging, perianal ulcer with bluish edges for 3 months. The biopsy specimen from the ulcer revealed tuberculoid structure with Langhans giant cells in the deep dermis and a few acid-fast bacilli. AFB cultures from the sputum, pus, and tissue were successful. Intradermal test with PPD showed positive result. Chest roentgenographic findings disclosed advanced pulmonary tuberculosis. Almost complete healing of the perianal ulcers occurred following 2 months of therapy using antituberculosis drugs.
Biopsy ; Dermis ; Giant Cells, Langhans ; Humans ; Intradermal Tests ; Middle Aged ; Sputum ; Suppuration ; Thorax ; Tuberculosis* ; Tuberculosis, Pulmonary ; Ulcer

Enlargement of bone tunnels has been noted on plain X-rays following arthroscopic ACL reconstruction. The cause of this widening is unclear, but it has been hypothesized that it may be due to either mechanical or biological cases. Ishibashi et al. reported anatomical proximal fixation resulted in the most stable reconstructed knee, with increasing instability as the level of fixation moved away from the tibial plateau. The purpose of this study is to determine if any difference exists in the amount of enlargement of the femoral tunnel following arhotoscopic ACL reconstruction with position of interference screw fixation and instability, and to know the factors which affected to the enlargement of the femoral tunnels. Total 39 patients were retrospectively reviewed for tunnel measurements radiologically at one year post-operation. (27 patients received bone-patellar tendon-bone autograft, 12 patients received bone-patellar tendon-bone autograft and Kennedy LAD-ligament augmentation device). The surgery was performed using an arthroscopic single and double incision technique. AP and lateral X-rays were obtained and the tunnels were measured by two independent observers using a digital caplper. The measurements were made at the widest part of the tunnel. Correction for magnification was performed by comparing the measured width of the interference screw used for fixation of the graft with its actual width. Statistical analysis was performed using a one-way analysis of variance(ANOVA) and t-test. 1. Radiographic tunnel enlargement of femoral side was average 2.42 mm (bone-patellar tendon-bone autograft : 2.36 mm, Kennedy-LAD and autograft : 2.56 mm)(p>0.05). 2. According to the position of the interference screw, the femoral tunnel enlargement were 2.25 mm in anatomical fixation, 2.40 mm in mid-tunnel fixation, 2.62 mm in mid-tunnel fixation, 2.62 mm in outer-tunnel fixation(p < 0.05). 3. The femoral enlargement according to the overall results(Clancy, 1982) were 2.39 mm in above good result group and 2.50 mm in below fair result group(p < 0.05). Tunnel enlargement group of femoral side was related to a distance between femoral articular surface and the position of interference screw. We conclude that femoral tunnel enlargement following arthoscopic bone tendon-bone ACL reconstruction is related to the mechanical effect rather than the properties of grafts and the clinical results.
Autografts ; Humans ; Knee ; Retrospective Studies ; Transplants

We reviewed 50 skin biopsies obtained from 40 patients with cutaneous leiomyoma during a 10 year period from January 1980 to December 1989. The result.s were summarized as follows: 1) Sex distribution showed a female preponderance with male.female ratio of 1: 1.9. 2) The age distribution was relatively even from childhood to old age. The mean age was 47,8 years, 3) The most common site of lesion was lower leg(34%) followed by hand(24%), foot(12% ), anterior chest(8% ), face(6% ), neck(4%), upper arm(4% ), labia major(2 %) and nipple(2%). 4) The lesions were relatively well circumscribed subcutaneous nodule, papule, plaque and nodule which measured between 0.3cm to 5cm in size and their colors were erythematous to light brown. 5) The most common clinical and histopathologic type was angioleiomyoma(75%) followed by solitary piloleiomyoma(12.5%), multiple piloleiomyoma(7,5%) and solitary genital leiomyoma(5% ). Angioleiomyomas were clincally associated with cavernous hemangioma, myoma of uterus and systemic lupus erythematosus. 7) The clinical diagnoses were mass(30% ), epidermal cyst(20%), dermatofibroma (12.5% ), leiomyoma(12,5%), neurilemmoma(5%), lipoma(5%), calcifying epithelioma(2.5%), metastatic carcinoma(2.5%), morphea(2.5% ), fibrocystic disease(2.5%), glomus tumor(2.5 % ) and Dupuytrens contracuture(2..5%).
Age Distribution ; Angiomyoma ; Biopsy ; Diagnosis ; Female ; Hemangioma, Cavernous ; Histiocytoma, Benign Fibrous ; Humans ; Leiomyoma ; Lupus Erythematosus, Systemic ; Myoma ; Sex Distribution ; Skin ; Uterus

The spinal fusion is used for correcting malformations, stabilizing unstable segments, and suppressing the progression of disease, but it causes more load on the adjacent segment and as a result, the degenerative changes accelerate. Furthermore, the accelerated changes case spinal stenosis, degradation of nucleus pulposus, degenerative spondylolisthesis, acquired isthmus defect, and arthritis of articular facet, it rarely needs surgical treatment. The purpose of this study is to know the effect of the fusion level and range on the adjacent segment, to be a standard for determining the fusion range prior to operation, and to help to find the complication like degenerative changes by measuring the range of motion on the adjacent segment after the spinal fusion. Authors analyzed the result of 29 cases of posterolateral lumbar spinal fusion which were operated from February 1989 and January 1994. The intervertebral angle was measured on the flexion and extension lateral radiographs, and the calculated angular motion and sagittal plane rotation at follow-up periods were compared with those of preoperative values. The results were as follows; 1. Among the adjacent segm0ent, the increment of angular motion of superior adjacent segment was 2.6°(-5°~15°) which was higher than that of inferior one with 1.5°(-3°~7°) 2. The increment of angular motion of superior adjacent segment for 1 segment rather than 2 or 3 segments was more than two times with 3.9°(-2°~15°) 3. Regardless of level and range of fusion, the increment of angular motion was 3.0°(-2°~8°) on 4.5th lumbar segment which was increased mostly and 1.5°(-3°~7°) on 5th lumbar and 1st sacral segment which was increased leastly. 4. There were 3 cases showed instability at the superior adjacent segment and no cases showed instability at the inferior adjacent segment among all the cases showing stability prior to operations. In conclusion, the sagittal plane rotation was increased in adjacent segment after posterolateral spine fusion. So, we would recommend that the adjacent segment is very important to the decision of fusion extent and level.
Arthritis ; Follow-Up Studies ; Range of Motion, Articular ; Spinal Fusion ; Spinal Stenosis ; Spine ; Spondylolisthesis

The medial collateral ligament(MCL) of the knee is the well established secondary restraint to the anterior displacement of the knee joint. However, there has been no report about the estimation of the anterior displacement in combined ACL(anterior collateral ligament) and MCL injures according to period when they were treated with conservative measures. This prospective study evaluated the changes of anterior displacement over time in combined ACL/MCL injury as the MCL injury heals after initial conservative measures. 19 patients who had combined ACL/MCL injury were followed during twelve months after injury. All patient had a positive Lachman test and were evaluated the side to side differences on KT-2000 knee arthrometer(Medmetric, San Diego, California) testing under 20 Ibs anterior tibial loading at 30 degree knee flexion. The stability of the knee was assessed using KT-2000 knee arthrometer every 8 weeks with clinical examination prospectively. They were treated with CI (Combined instability) brace (Smith & Nephew, Carlsbad, California) as conservative measures. Overall, Initial side to side difference of the anterior displacement was averaged 5.21mm (range,4.0-7.0mm) and 3.30mm (range,2.0-5.5mm) finally. According to the classification of MCL injury, in Grade III groups, they had the greatest initial anterior displacement about 6.4mm, but tight- ened the most to 3.08mm finally. In Grade II and Grade I groups they showed 2.97mm and 2.13mm side to side difference (p>0.01). However in Grade I, the anterior displacement were decreased by 4 months after injury but, it were increased at 6 months after injury. In Grade II and III, the decrement of the anterior displacement were continued by 6 months after injury, but they were not changed after that. The data was analyzed by General Linear Model Procedure method. Conclusively, the anterior displacement of knee in patients with combined ACL/MCL injury was diminished with the time in the majority of patients as the MCL healed. It means that the MCL was the stabilizer to the anterior displacement of the knee under the anterior tibial loading.
Braces ; Classification ; Humans ; Knee Joint ; Knee* ; Linear Models ; Prospective Studies

No abstract available.
Coronary Artery Bypass* ; Coronary Vessels*

No abstract available.
Pneumothorax*

No abstract available.
Adolescent* ; Humans

Median raphe cyst is not a cornmon disease and represents a defect in the embryologic development of male genitalia. It occurs most commonly near the glans penis, but may occur anywhere from the urethral meatus to the anus, and is lined by entodermal or ectodermal epithelium. Surgical excision is the treatment of choice. Recently we observed a 29-year-old male patient who had had a typical median raphe cyst since childhood on the ventral aspect of the glans penis. On histological examination, the cyst was lined by stratified columnar epithelium varied from four to eight cells in thickness.
Adult ; Anal Canal ; Ectoderm ; Epithelium ; Genitalia, Male ; Humans ; Male ; Penis*