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

PURPOSE: The purpose of our study is to evaluate the diagnostic significance of clinical findings, WBC count, ESR, CRP, simple X-ray, ultrasonography and bone sanning in neonates. MATERIALS AND METHODS: From January 1995 to May 1998, we have experienced 14 cases of pyogenic osteomyelitis and pyogenic arthritis in neonates. The mean age of patients was 16.7 days and the involved sites were 6 cases of pyogenic arhtritis of hip, 5 cases of pyogenic arthritis of hip with proximal femur osteomyelitis, 2 cases of pyogenic arthritis of shoulder with proximal humerus osteomyelitis and 1 case of proximal tibia osteomyelitis. RESULTS: The most frequent clinical signs were local swelling and pseudoparalysis of involved extremity. Laboratory findings showed that elevated ESR was in 11/14 (79%), positive CRP in 6/8 (75%), leukocytosis in 6/14 cases (43%). Abnomal findings in simple X-ray was in 7/13 (54%), positive bone scanning findings in 3/8 (37.5%), positive ultrasonographic findings in 11/11 cases (100%). CONCLUSIONS: ITherefore we concluded that careful physical examination and ultrasonography were important for early diagnosis of bone or joint infection in neonates
Arthritis ; Diagnosis* ; Early Diagnosis ; Extremities ; Femur ; Hip ; Humans ; Humerus ; Infant, Newborn* ; Joints* ; Leukocytosis ; Osteomyelitis ; Physical Examination ; Shoulder ; Tibia ; Ultrasonography

PURPOSE: The purpose of this study is to prove the effects of topical anesthetics (EMLA) to control pain in preterm infants during invasive procedure (percutaneous central venous catheterization, PCVC). METHODS: A total of 18 preterm infants of birth weight <2,000 g and gestational age <36 weeks born at EulJi University Hospital, at Daejeon in 2010 were randomly included in this study. EMLA was applied in nine preterm infants 40 minutes before starting PCVC and placebo was applied in another nine preterm infants. Based on PIPP (preterm infant pain profile), we evaluated their heart rate, oxygen saturation before, 15 seconds during and 30 seconds after procedure. Behavioral responses were also recorded for 2 minutes after procedure. RESULTS: Experimental group showed significantly less behavioral response during procedure (P=0.005) and 2 min after procedure (P=0.001). Also, experimental group showed less increase in heart rate (P=0.033) and reduction of behavioral state (P=0.017). CONCLUSION: Despite limitation of small size in this study, experimental group showed lower pain score compared with placebo control group during catheterization. In neonatal care unit (NICU), we recommend the use of topical anesthetics such as EMLA to control pain during invasive procedures.
Anesthetics ; Birth Weight ; Catheterization ; Catheterization, Central Venous ; Catheters ; Central Venous Catheters ; Gestational Age ; Heart Rate ; Humans ; Infant ; Infant, Newborn ; Infant, Premature ; Lidocaine ; Oxygen ; Prilocaine

Congenital coronary arteriovenous fistula is a rare condition which is an abnormal communication of the coronary artery with the right ventricle, right atrium, left atrium or left ventricle. Coronary artery aneurysm is an uncommon disease which is defined as coronary dilatation which exceeds the diameter of normal adjacent segments or the diameter of the patient's largest coronary vessel by 1.5 times. In young ages, symptoms are unusual, but significant symptoms and complications such as congestive heart failure, subacute bacterial endocarditis, coronary steal syndrome, aneurysm formation, rupture, and pulmonary hypertension may appear among the older age group. We report a case of giant aneurysm of a congenital coronary arteriovenous fistula between left co-ronary artery and right ventricular outflow tract with significant left to right shunt confirmed in a 84-year old female with a brief review of literature.
Aged, 80 and over ; Aneurysm* ; Arteries ; Arteriovenous Fistula* ; Coronary Aneurysm ; Coronary Vessels* ; Dilatation ; Endocarditis, Subacute Bacterial ; Female ; Heart Atria ; Heart Failure ; Heart Ventricles ; Humans ; Hypertension, Pulmonary ; Rupture

PURPOSE: The aim of study was to review the results of open surgical repair (OSR) of chronic juxtarenal aortic occlusion (JRAO). MATERIALS AND METHODS: We retrospectively reviewed the results of OSR performed in 47 patients (male, 92%; mean age, 59.9+/-9.3 years [range, 44-79]) with chronic JRAO during the past 21 years. In order to reduce intraoperative renal ischemic time (RIT), we excised a portion of the occluded segment of the infrarenal aorta without proximal aortic clamping. We then performed suprarenal aortic clamping with both renal arteries clamped, removed the proximal aortic thrombus cap, confirmed both renal artery orifices, and moved the suprarenal aortic clamp to the infrarenal aorta to allow renal perfusion and standard aortoiliac reconstruction. We investigated early (<30 days) postoperative surgical morbidity (particularly renal function), operative mortality, and longterm patient survival. We conducted risk factor analysis for postoperative renal insufficiency. RESULTS: The mean intraoperative RIT was 10.7+/-5.5 minutes (range, 3-25), including 6 patients who underwent concomitant pararenal aortic thromboendarterectomy. Postoperatively, five (11%) patients had transient renal insufficiency, one had pneumonia, and one patient had an acute myocardial infarction. However, there was no operative mortality or newly developed dialysis-dependent renal failure. Postoperative follow up was available in 36 (77%) patients for a mean period of 6.3 years (range, 1 month-17 years). Kaplan Meier calculations of patient survival at 5 and 10 years after surgery were 91.2% and 83.6%, respectively. CONCLUSION: We have experienced short RIT, acceptable early postoperative results and long-term survival after OSR of chronic JRAO.
Aorta ; Constriction ; Endarterectomy ; Follow-Up Studies ; Humans ; Mortality ; Myocardial Infarction ; Perfusion ; Pneumonia ; Renal Artery ; Renal Insufficiency ; Retrospective Studies ; Risk Factors ; Thrombosis

No abstract available.
Erythema* ; Flushing* ; Rosacea*

A diagnosis of gout is often straightforward because gout has well known clinical presentations, laboratory analyses, and radiologic features. On the other hand, gout can mimic other diseases by showing a range of atypical clinical manifestations. This paper reports a 35-year-old male with no prior history of gout who developed tophaceous gout at his previously repaired Achilles tendon 11 years after surgery. He was initially misdiagnosed with cellulitis because of his atypical clinical features. This case is presented with a review of the relevant literature.

Clear cell sarcoma of tendon and aponeurosis is a rare malignant tumor. It occurs chiefly in young adults, predominates in women and is most common in the regions of the foot and ankle. We report a case of clear cell sarcoma of tendon and aponeurosis in s 22-year-old man. he pstient had had a asymptomatic, normal skin colored, relativerly hard, dome shsped nodule on the anterior chest for 6 months. Histopsthologic findings revealed uniform pattern composed of compact nests of round or fusiform cells which had clear cytoplasm and were surrounded by delicate framework of fibrocollagenous tissue, and the individual tumor cell had a fairly regular appearance of possessing round to avoid vesicular nucleus with prominent basophilic nucleolus. One year after surgical excision and post operative radiotherapy, there was no recurrence.
Ankle ; Basophils ; Cytoplasm ; Female ; Foot ; Humans ; Radiotherapy ; Recurrence ; Sarcoma, Clear Cell* ; Skin ; Tendons ; Thorax* ; Young Adult

Behcet's disease is characterized by recurrent orogenital ulcers and ocular and cutaneous inflammatory lesions. Cardiovascular involvement, which may be artrial or venous, is rare but carries a particularly poor prognosis. One of the known vascular complications of Behcet's disease is aneurysm formation or venous thrombosis. We recently experienced a Behect's disease with multiple arterial aneurysms and thrombosis and report this case with review of literatures.
Aneurysm* ; Prognosis ; Thrombosis* ; Ulcer ; Vasculitis ; Venous Thrombosis

PURPOSE: The purpose of this study was to identify the frequency of urinary incontinence and lower urinary symptoms, to identify lifestyle and sexual matters for UI of adult women in an urban area. METHOD: The sample consisted of 364 educated women from a women's health education program in a public health center. For data collection, the Bristol Female Lower Urinary Tract Symptoms Questionnaire developed by Jackson, et. al.(1996) and the demographic questionnaire were used. For data analysis, SAS 8.2 program was used. RESULT: The results were as follows: 1. the prevalence rate of UI was 73.63%. 45.88% of them were stress incontinence and 27.75% of them were urge incontinence. 2. Remarkable differences were found between the type of UI and LUTS in the case of urgency(x2=42.0585, P<0.001), unexplained incontinence(x2=59.0585, P<0.001), noctural incontinence(x2=18.8080, P<0.001) and catetherization(x2=10.7207, P= 0.004), burning sense(x2=27.7400, P<0.001). 3. Remarkable differences were found between the type of UI and lifestyle matters in the cases as follows fluid intake restriction(x2=31.0532, P=0.008), interference in physical activity(x2= 36.7481, P=0.001), interference in relation with others(x2=22.2729, P=0.034). 4. Remarkable differences were found between the type of UI and sexual matters with difficulty of sexual intercourse(x2=16.1898, P=0.002), and urine leakage during sexual intercourse(x2=17.9752, P=0.001). CONCLUSION: Based on the results, developing and carrying out an adequate UI care and education program is needed.
Adult ; Burns ; Data Collection ; Education ; Female ; Humans ; Life Style* ; Lower Urinary Tract Symptoms* ; Prevalence ; Public Health ; Statistics as Topic ; Urinary Incontinence* ; Urinary Incontinence, Urge ; Women's Health ; Surveys and Questionnaires