Spontaneous testicular hemorrhagic necrosis is a rare disease usually associated with testicular torsion. Partially involved and suspicious testis tumor cases are also defined from orchiectomy specimens. Herein, a spontaneous hemorrhagic necrosis, without any testicular torsion, but with involvement of the whole testicle and epididymis, is reported. A 21 year old patient, who presented with a painless left testicular enlargement of several days duration was believed, based on physical examination, ultrasonography and elevation of serum LDH, to have a testicular tumor. Diagnosis was made only after radical orchiectomy and histopathological examination.
Diagnosis ; Epididymis ; Hemorrhage ; Humans ; Male ; Necrosis* ; Orchiectomy ; Physical Examination ; Rare Diseases ; Spermatic Cord Torsion ; Testis* ; Ultrasonography ; Young Adult

Enchondroma is a benign tumor mainly developed in the hand and uncommon in the foot. Even if it is in the foot, most are in the phalanges and distal metatarsals of the foot. Enchondroma in the calcaneus is very rare. A 44-year-old male suffered from left heel pain for several months, authors treated it with curettage and bone graft, it was histologically confirmed as an enchondroma in the calcaneus. The authors presented a rare case presentation of an enchondroma in the calcaneus with pain.
Adult ; Calcaneus ; Chondroma ; Curettage ; Foot ; Hand ; Heel ; Humans ; Male ; Metatarsal Bones ; Transplants

BACKGROUND: Brief episode of coronary artery occlusion (i.e., ischemic preconditioning) makes the heart more resistant to injury from a subsequent ischemic insult. Although a great deal of effort has been made in studying ischemic preconditioning, the underlying mechanism of ischemic preconditioning and its effect on hypothermic insult has not been elucidated. This study was performed to see whether ischemic preconditioning protects against the depression of cardiac contractility induced by hypothermic cardioplegic arrest/reperfusion. And recently, adenosine was known to have some correlation with the mechanism of preconditioning. If so, does this effect remain after the blockade of adenosine receptor by 8-phenyl theophylline? METHOD: Twenty-four Sprague-Dawley rat weighed 250-350g were used and divided into three groups. Rat hearts were removed rapidly, and each isolated heart paced with a rate of 180/min was perused by modified Krebs-Hensleit buffer(KHB) solution on a Langendorff apparatus far an hour. After obtaining baseline data including left ventricular pressure(LVP), dp/dt, and coronary flow, cardiac arrest was induced by perfusion of 0degrees C crystalloid cardioplegic(St Thomas) solution. After that, all hearts were stored in the same St Thomas solution at salute temperature far 2 hours. In group I (control group), the hear was reperfused by KHB solution. In group II(preconditioning group), the heart was subjected to two 2-minute episode of global ischemia followed by 5 minute reperfusion with KHB solution(preconditioning) before cardiac arrest. In group III(phenyl theophylline group), the heart was subjected to preconditioning procedure and 8-phenyl theophylline at 10muM in concentration was added to KHB solution at time of reperfusion. Observing parameter was obtained in each group at 10, 20, 40 and 60 minutes after starting reperfusion and compared statistically by use of one way ANOVA test(STASTICA, release 4.5). P-value less than 0.05 was considered significant. RESULTS: Although depressed LVP, dp/dt, and Coronary flow were seen in all groups during the reperfusion period, the preconditioned group showed more effective recovery of LVP than that of the control group, especially at 10, 20 and 40 minutes(p<.05). We failed to demonstrate the difference between the phenyl theophylline group and the control group(p=NS). CONCLUSION: These results suggest that ischemic preconditioning has protective effect on recovery state of hypothermic cardioplegic arrest/reperfusion. Its protective effect was limited during early reperfusion stage and was blocked by adenosine blocker.
Adenosine ; Animals ; Coronary Vessels ; Depression ; Heart Arrest ; Heart* ; Ischemia ; Ischemic Preconditioning* ; Myocardium* ; Perfusion ; Rats ; Rats, Sprague-Dawley ; Receptors, Purinergic P1 ; Reperfusion ; Theophylline

A severe chemical or thermal injury is a troublesome ocular insult, which usually results in persistant corneal epithelial defect, stromal scarring, and neovascularization. For resurfacing chemically burned cornea, limbal autograft transplantation is presented in 2 cases of chemical and/or thermal injury with follow-up of 6, 8 months. The operative technique involved transfer of four free grafts of limbal tissue from the uninjured fellow eye to the severely injured eye. Clinical results of the cases have shown surface healing with stable epithelial adhesion without recurrent erosion or persistant epithelial defect.
Autografts* ; Burns* ; Cicatrix ; Cornea ; Follow-Up Studies ; Transplants

Magnetic resonance imaging(MRI) is accepted as a useful tool for the diagnosis of injury of the knee recently. The anterior cruciate ligament tear is accompanied by the damage of the osseous and soft tissue of the knee. The occult osseous lesion is found on magnetic resonance imaging as bone density change that is not found on the simple radiograph. From Jan. 1992 to Apr. 1994, magnetic resonance imaging was performed on 44 patients with acute anterior cruciate ligament tears. MRI was done within 6 weeks of the index anterior cruciate ligament injury. The criteria of decreased signal intensity on the Tl weighted image and increased signal intensity on the T2 weighted image was applied for the incidence assessment of the occult osseous lesion. After arthroscopy with or without ACL reconstruction, follow-up simple radiograph was checked every 3 months. Occult osseous lesions were documented in 32(73%) of the 44 patients. Of the 32 patients with bony lesion, 81% had lesions of the lateral compartment. Lateral femoral condyle was involved in 15 cases(46.9%), and lateral tibial plateau in 22 cases (68.8%). Follow-up X-ray revealed no joint deperession in all of the 32 patients with the occult osseous lesion. This result suggests that there is a high correlation between the occult osseous lesion of lateral compartment of the knee on magnetic resonance imaging and anterior cruciate ligament tear. The presence of the occult osseous lesion in the patient with acute anterior cruciate ligament tear did not affect rehabilitation and weight bearing.
Anterior Cruciate Ligament ; Arthroscopy ; Bone Density ; Diagnosis ; Follow-Up Studies ; Humans ; Incidence ; Joints ; Knee ; Magnetic Resonance Imaging ; Rehabilitation ; Tears ; Weight-Bearing

Three-dimensional surgical accuracy between virtually planned and actual surgical movements of the maxilla in two-jaw orthognathic surgery.

Three-dimensional surgical accuracy between virtually planned and actual surgical movements of the maxilla in two-jaw orthognathic surgery.

BACKGROUND: The execution of fibular allograft augmentation in unstable proximal humerus fractures (PHFs) was technically demanding. In this study, the authors evaluated the clinical and radiographic outcomes after tricortical iliac allograft (TIA) augmentation in PHFs. METHODS: We retrospectively assessed 38 PHF patients treated with locking-plate fixation and TIA augmentation. Insertion of a TIA was indicated when an unstable PHF showed a large cavitary defect and poor medial column support after open reduction, regardless of the presence of medial cortical comminution in preoperative images. Radiographic imaging parameters (humeral head height, HHH; humeral neck-shaft angle, HNSA; head mediolateral offset, HMLO; and status of the union), Constant score, and range of motion were evaluated. Patients were grouped according to whether the medial column support after open reduction was poor or not (groups A and B, respectively); clinical outcomes were compared for all parameters. RESULTS: All fractures healed radiologically (average duration to complete union, 5.8 months). At final evaluation, the average Constant score was 73 points and the mean active forward flexion was 148°. Based on the Paavolainen assessment method, 33 patients had good results and 5 patients showed fair results. The mean loss of reduction was 1.32 mm in HHH and 5.02% in HMLO. None of the parameters evaluated showed a statistically significant difference between the two groups (poor and not poor medial column support). CONCLUSIONS: In unstable PHFs, TIA augmentation can provide good clinical and radiological results when there are poor medial column support and a large cavitary defect after open reduction.
Allografts ; Head ; Humans ; Humerus ; Methods ; Range of Motion, Articular ; Retrospective Studies

This study was performed to describe the longitudinal management of recurrent temporomandibular joint (TMJ) ankylosis from infancy to adulthood in perspective of surgical and orthodontic treatment. A 2-year-old girl was referred with chief complaints of restricted mouth opening and micrognathia due to bilateral TMJ ankylosis. For stage I treatment during early childhood (6 years old), high condylectomy and interpositional arthroplasty were performed. However, TMJ ankylosis recurred and symptoms of obstructive sleep apnea (OSA) developed. For stage II treatment during early adolescence (12 years old), gap arthroplasty, coronoidectomy, bilateral mandibular distraction osteogenesis, and orthodontic treatment with extraction of the four first premolars were performed. However, TMJ ankylosis recurred. Because the OSA symptoms reappeared, she began to use a continuous positive airway pressure device. For stage III treatment after completion of growth (20 years old), low condylectomy, coronoidectomy, reconstruction of the bilateral TMJs with artificial prostheses along with counterclockwise rotational advancement of the mandible, genioglossus advancement, and orthodontic treatment were performed. After stage III treatment, the amount of mouth opening exhibited a significant increase. Mandibular advancement and ramus lengthening resulted in significant improvement in the facial profile, Class I relationships, and normal overbite/overjet. The OSA symptoms were also relieved. These outcomes were stable at the one-year follow-up visit. Since the treatment modalities for TMJ ankylosis differ according to the duration of ankylosis, patient age, and degree of deformity, the treatment flowchart suggested in this report could be used as an effective guideline for determining the appropriate timing and methods for the treatment of TMJ ankylosis.

OBJECTIVE: There are various surgical approaches to far-lateral lesions in the L5-S1 intervertebral space. Of these is the validity of a paramedian tangential approach is being investigated in this study. METHODS: A retrospective study was conducted on 25 patients who had been diagnosed as having a far-lateral L5-S1 disc herniations, osteophyte, costal process hypertrophy, and had undergone a paramedian tangential approach from November 1999 through December 2003. The degree of symptoms and improvement were compared via the visual analog pain scale, before and after surgery. RESULTS: This study included 4 males and 21 females with a mean age of 62+/-11.8 years old. The average follow-up period after surgery was 8.2+/-2.7 months. The visual analog pain scale taken before surgery was 6.7+/-1.1 points, while the post-surgical scale was 2.4+/-0.9 points showing a significant decrease (p<0.05). There were no complications that developed during surgery. CONCLUSION: A paramedian tangential approach is less invasive in the soft tissue than that of the median approach. This approach may effectively reduce nerve root compression and expand intervertebral foramens, and is devoid of the risk of spinal instability after surgery. The authors suppose that a paramedian tangential approach is quite an effective technique to relieve compression in the far-lateral L5-S1 intervertebral space.
Female ; Follow-Up Studies ; Humans ; Hypertrophy ; Male ; Osteophyte ; Pain Measurement ; Radiculopathy ; Retrospective Studies