No abstract available.
Lymphangioma, Cystic*

Genu recurvatum deformity of the knee can be due to the deformity of the bone of the proximal end of the tibia or to the changes in the soft tissues, or both. The causes of acquired genu recurvatum include trauma, wire traction of the tibia, operative procedures involving the proximal tibial physis, Osgood-Schlatter's disease, osteomyelitis and prolonged immobilization. The most frequent symptoms of genu recurvatum are weakness, pain and instability of the knee, genu valgus, and shortening of the affected lower extremity. Operative treatment consists of tibial osteotomy and soft tissue procedures performed on the capsule and ligaments, and recently percutaneous corticotomy of the proximal tibia and gradual correction by the Ilizarov external fixator became one of the treatment modalities. From Nov. 1990 to June 1993, the authors have performed gradual correction by the Ilizarov external fixator in 6 patients of genu recurvatum and the results were as follows. 1. The mean age was 14 years ranging from 11 to 21. And there were 2 males and 4 females. 2. In the past history, there were ipsilateral femur fractures in 5 cases in which 4 cases were treated with skeletal pin traction on the proximal tibia, and one case had ipsilateral open tibiofibular fracture. 3. After Ilizarov external fixation, proximal tibial corticotomy just inferior to the tibial tuberosity were performed in all 6 cases. 4. The follow up period was 19 months in average. 5. The results were evaluated according to a scoring system that was suggested by Lecuire et al.: 2 cases were excellent, 3 cases were good and 1 case was fair. 6. Ilizarov gradual correction was very effective not only in the treatment of genu recurvatum but also in the concurrent correction of limb length inequality and mechanical axis deviation of the lower extermity.
Congenital Abnormalities ; External Fixators ; Extremities ; Female ; Femur ; Follow-Up Studies ; Humans ; Immobilization ; Knee ; Ligaments ; Lower Extremity ; Male ; Osteomyelitis ; Osteotomy ; Socioeconomic Factors ; Surgical Procedures, Operative ; Tibia ; Traction

No abstract available.
Gynecology*

No abstract available.
Sensation* ; Zygote Intrafallopian Transfer*

Severe sepsis and septic shock are the main causes of death in critically ill patients. Early detection and appropriate treatment according to guidelines are crucial for achieving favorable outcomes. Endotoxin is considered to be a main element in the pathogenic induction of gram-negative bacterial sepsis. Polymyxin B hemoperfusion can remove endotoxin and is reported to improve clinical outcomes in patients with intra-abdominal septic shock, but its clinical efficacy for pneumonic septic shock remains unclear. Here, we report a case of a 51-year-old man with pneumonic septic shock caused by Pseudomonas aeruginosa, who recovered through polymyxin B hemoperfusion.
Cause of Death ; Critical Illness ; Gram-Negative Bacteria* ; Hemoperfusion* ; Humans ; Middle Aged ; Polymyxin B* ; Polymyxins* ; Pseudomonas aeruginosa ; Sepsis ; Shock, Septic*

Solitary rectal ulcer syndrome (SRUS) is an uncommon benign disease that is misdiagnosed as malignancy or inflammatory bowel disease because of similarities in clinical and endoscopic manifestations. Furthermore, SRUS with ulcerative colitis (UC) is extremely rare. To date, two cases have been reported in the medical literature. We report an additional case of SRUS with UC that was misdiagnosed as rectal cancer. A 61-year-old man was admitted to our hospital with rectal bleeding. Colonoscopy showed a well-demarcated, shallow, ulcerative lesion with polypoidal growth involving the entire circumference of the rectal lumen. Findings from imaging studies, including abdominal computed tomography (CT) and positron emission tomography (PET)/CT resembled those of rectal cancer. Surgical resection was performed because clinical symptoms persisted despite medical treatment and because occult rectal cancer could not be ruled out. Histopathological examination of the resected specimen revealed fibromuscular obliteration of the lamina propria and crypt abscesses, characteristics compatible with SRUS and UC.
Abscess ; Colitis, Ulcerative* ; Colonoscopy ; Hemorrhage ; Humans ; Inflammatory Bowel Diseases ; Middle Aged ; Mucous Membrane ; Positron-Emission Tomography ; Rectal Neoplasms ; Ulcer*

Carcinoid tumors of the intestinal tract are uncommon neoplasms thought to arise from argentaffin cells in the base of the intestinal crypts. Carcinoid tumors of other sites have since been reported with increasing frequency. We experienced one case of rectal carcinoid tumor and the other case of stomach carcinoid turnor. A 52-year-old male patient was admitted to the hospital because of right upper abdominal discomfort. On the CT scan, multiple low density masses were noticed. Sigmoidoscopy revealed the whitish yellow ulcerofungating mass which had vague margin. And a 31-year-old male patient was admitted to the haspital because of hematemesis. On the gastrofiberscopic examination, an ovoid shallow ulcer crater which had elevated margin, smooth tapered fold and vissible vessel was noticed on the anterior wall side of the high body. The biopsy specimen in both these cases showed carcinoid cells. 24h urine 5-HIAA of these cases was negative. Awareness of carcinoid tumor in differential diagnosis of hepatic metastasis and of gastric ulcer is necessary.
Adult ; Biopsy ; Carcinoid Tumor* ; Diagnosis, Differential ; Enterochromaffin Cells ; Hematemesis ; Humans ; Hydroxyindoleacetic Acid ; Male ; Middle Aged ; Neoplasm Metastasis ; Rectum* ; Sigmoidoscopy ; Stomach Ulcer ; Stomach* ; Tomography, X-Ray Computed ; Ulcer

This study was designed to investigate effectiveness of fragmentation during lithotripsy using 103 intrahepatic stones collected from 10 patients. Who had previously undergone biliary surgery. The size of each stones was measured and sonography was performed for the evaluation of the sonographic type of the stones. In vitro lithotripsy was performed on individual stones using piezoelectric lithotriptor to evaluate the fragmentation rate and average number of shock waves for fragmentation. Chemical analysis of each stone was done to determine chemical composition including calcium, bilirubin, and cholesterol. The size of the stones was from 5mm to 20 mm in diameter. Sonographic type I(echo of whole stone with posterior acoustic shadow) was 68, and type II(are-like strong surface echo of stone with clear posterior acoustic shadow) was 35 in number. The majority(78%) of stones I group 1 (5-9mm in diameter) showed sonographic type I characteristics, and 62% of stones in group 3(larger than 15mm in diameter) showed sonographic type Ii characteristics. There was a positive correlation between the size and sonographic type of stones. Fragmentation rates of stones were 100% in group 1. 71.9% in group 2 (10-15 mm in diameter), 43.8% in group 3. Respectively. Fragmentation rates of stones with sonographic type I and II were 91.2%, 65.7%. respectively. The average number of shock waves for partial and complete fragmentation was 2753±4937 and 6219±10133. Respectively. There was a positive correlation between the number of shock waves for fragmentation and diameter of stones (r=0.618. p<0.05). There was no correlation between the number of shock waves for fragmentation and chemical composition of stones. In conclusion, the most important variable determining the degree of fragmentation of intrahepatic stones using ESWL is not their chemical composition but their size and sonographic characteristics.
Acoustics ; Bilirubin ; Calcium ; Cholesterol ; Humans ; In Vitro Techniques* ; Lithotripsy* ; Shock* ; Ultrasonography

OBJECTIVE: To evaluate the changes in mammographic density by different types of hormone replace therapy (HRT) in postmenopausal women. METHODS: A total of 150 postmenopausal women who received same HRT regimen for 1 year were classified as the four groups according to the regimen of HRT; 1) daily conjugated equine estrogen (CEE) 0.625 mg+medroxiprogesterone acetate (MPA) 2.5 mg (CEE/MPA-continuous, n=42), 2) daily CEE 0.625 mg+MPA 10 mg on days 1-12 (CEE/MPA-cyclic, n=28), 3) daily CEE 0.625 mg (CEE only, n=40), 4) daily tibolone 2.5 mg (Tibolone, n=40). And 40 women were allocated as control group. The changes in mammographic density in each group were compared with before and after HRT for 1 year. RESULTS: The increase in mammographic density after 1 year of HRT was significantly higher in CEE/MPA-continuous group and CEE/MPA-cyclic group compaired with control group (p<0.05), and was not observed in CEE only group and tibolone group. CONCLUSION: Our results suggest that greater increase of mammographic density in postmenopausal women was significantly associated with estrogen/progestin combination therapy.
Estrogens ; Female ; Humans ; Mammography

The anomalous origin of the right coronary artery from the main pulmonary artery has been rarely reported. We report a 63-year-old male with angina pectoris who was shown to have an anomalous origin of the right coronary artery from the main pulmonary artery. The abnormal origin was identified by conventional coronary angiography, but the abnormal course of the artery was precisely delineated by high resolution multi-slice computerized tomography. The patient underwent successful surgical correction of the anomalous vessel with complete resolution of symptoms.
Adult ; Angina Pectoris ; Arteries ; Coronary Angiography ; Coronary Artery Disease ; Coronary Vessel Anomalies ; Coronary Vessels ; Glycosaminoglycans ; Humans ; Male ; Middle Aged ; Pulmonary Artery