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Hip

Purpose: This study examined the changes in the body mass index (BMI) and the effects of BMI on the knee function and risk factors for an increase in BMI after total knee arthroplasty (TKA) in Asians. Materials and Methods: A prospective observational study was conducted on 100 cases of TKA performed by one surgeon. Obesity was defined as BMI ≥25 kg/m 2 . The BMI and Knee Society Score, consisting of the Knee Score and Function Score, were measured on the day before surgery and one year after surgery. Results: The BMI decreased or was maintained in 34 cases (34%) and increased in 66 cases (66%) one year after surgery. An increase in BMI of 5% or more was considered a clinically significant increase in BMI and occurred in 28 cases (28%). The patients with an increased BMI by more than 5% showed a significantly lower knee function score. The age and preoperative function score were significantly associated with an increased BMI by more than 5%. As the age increased by one year, the odds ratio at which the BMI would increase by more than 5% one year after surgery was 0.905. Moreover, as the preoperative function score increased by one point, the odds ratio that the BMI would increase by 5% one year after surgery was 0.902. In other words, a younger preoperative age and a lower preoperative function score mean a higher risk of a more than 5% postoperative increase in BMI. Conclusion The BMI increased by more than 5% one year after surgery in 28% of the TKA patients examined. They had a lower functional score. The risk factors for a more than 5% increase in BMI after TKA were young age and a low preoperative function score. Therefore, surgeons should educate patients, particularly those who are young or have a low preoperative function score, so that the patient’s BMI would not increase after surgery.

BACKGROUND: renal artery stenosis (RAS) is a major cause of renovascular hypertension and renal function due to ischemic atrophy of kidney. There are several methods to treat the RAS, including are surgery, percutaneous transluminal renal angioplasty, and medical treatment. The purpose of this study is to evaluate the usefulness, safety, and efficacy of percutaneous transluminal stent deployment in RAS. METHOD: From January 1995 to July 1996, 17 patients underwent renal stent implantation due to renal artery stenosis (11 male, 6 female). the mean age was 49 years old, one patient had both renal artery stenosis and total lesions were 18. The causes of renal artery stenosis were atherosclerosis in 12, fibromuscular dysplasia in 2, Takayasu's disease in 2, and autoimmune disease (Bechet's) in one case. Renal artery stenting was performed via femoral artery in 12 lesions and brachial artery in 6 lesions. Follow up was performed by renogram, renal angiogram, and clinical examination. RESULT: the degree of renal artery stenosis was 83% (70-95%). the lesion sites were 12 ostial and 6 non-ostial lesions. The used renal stents were Palmaz-biliary stent in 17 lesions and Micro-2 stent in one lesions. All stents were implanted successfully and there was no residual stenosis in all patients except one case showed 20% residual stenosis due to huge renal artery size. The transstenotic pressure gradients after renal artery stenting was decreased markedly from 74mmHg to 2mmHg. There no serious complications such as a death, emergency surgery, or nephrectomy. There were two minor complications which were one case of pyelonephritis and one case of inguinal hematoma. After stenting, blood pressure was decreased partially in 13 patients and completely in 2 cases. CONCLUSION: Renal artery stenting appears to be safe and feasible and the alternative treatment modality to surgery for renal artery stenosis.
Angioplasty ; Atherosclerosis ; Atrophy ; Autoimmune Diseases ; Blood Pressure ; Brachial Artery ; Constriction, Pathologic ; Emergencies ; Femoral Artery ; Fibromuscular Dysplasia ; Follow-Up Studies ; Hematoma ; Humans ; Hypertension, Renovascular ; Kidney ; Male ; Middle Aged ; Nephrectomy ; Pyelonephritis ; Renal Artery Obstruction* ; Renal Artery* ; Stents*

We report a case of plexiform neurofibroma developed under the overlying speckled lentiginous nevus, which occurred in a 20 year-old man. In this patient and his family no other signs of von Recklinghausens disease were found. Discussion is focussed on the fact that both plexiform neurofibroma and speckled lentigmous nevus, which represent a defect in the neural crest, occurred in the same area of the skin.
Humans ; Neural Crest ; Neurofibroma, Plexiform* ; Neurofibromatosis 1 ; Nevus* ; Skin

Leiomyoma Cutis is an unusual benign tumor of smooth muscle derivecl either from the arrector pili muscle, from the media of blood vesseles, or from smooth muscles of scrotum, labia or nipple. Two casea of leiomyoma cutis confirmed by H&E stain and Massons stain is presented, one with lesion on the left thigh and the ather with lesion of the left ankle. The first case was a 49 year-old female with solitary pinhead sized subcutaneous firm mass with intermittent pain and tenderess for 10 months, The second case waa a 36 year-old female with painful solitary peanut sized firm nodule which had pinkish center of 1 year duration.
Adult ; Ankle ; Blood Vessels ; Female ; Humans ; Leiomyoma* ; Middle Aged ; Muscle, Smooth ; Nipples ; Scrotum ; Thigh

Hypergammaglobulinemic purpura of Waldenstrom is a distinct syndrome consisting of recurrent episodes of purpura, elevated serum r-globulins, elevated erythrocyteed rnentation rate, and mild anemia. This disease has been divided into the prirnary type without an uncerlying disease, and the secondary type with a known underlying disease. We diagnosed a hypergammaglobulinemic purpura of Waldenstram in a 53-year-old woman who presented sudden onset of showers of purpuric macules and petechiae of 24 hours duration involving her lower extremities with a 10-rnonth history. She showed characteristic laboratory findings consistent with those of hypergammiglobulnemic purpura of Waldenstrorri and also showed positive results of antinuclear antibody and rheumatoid factor. We tried to find out if there we any associated underlying disases such as systemic lupus erythematosus or Sjogren synirorne through various tests but faile it find any. We concluded she showed a primary type of hypergarnmhglobulinemic purpura of Waldcnstrorn.
Anemia ; Antibodies, Antinuclear ; Erythrocytes ; Female ; Humans ; Lower Extremity ; Lupus Erythematosus, Systemic ; Middle Aged ; Purpura ; Purpura, Hyperglobulinemic* ; Rheumatoid Factor

BACKGROUND: It is well-known that the giant congenital nevi prcgress to malignant, melanama more frequently than other benign melanocytic nevi but to date the laor tory methods for early detection of such progression were not avsilable. The proliferating cell uncleai antigen(PCNA) staining has been regsrded as an useful marker in determining prognosis of some maignant diseases. OBJECTIVE: The PCNA taining was performed as a predictive value of malignant transformation from benign meanocytic skin lesions. We investigated the differcnces between malignant melanoma and the benign lesions. MATERIAL AND METHODS: Immunohistochemical study was employee using anti-PCNA, anti-S-100, and anti-CD45RO antibody in 6 giant congenital nevi, 8 small and medium sized congenital nevi, 10 acquired nevi, and 10 malignant meanomas. Only cells positive for both PCNA and S-100, and negative for CD45RO on the serial sections were identified as melanocyts. RESULTS: The number of PCNA-posit,ive cells per 1000 melanocy,es averaged 6.0+7.5 in giant, congenital nevi, 2.9+1,9 in small and medium sized congenital novi, 3.1+2.7 in acquired nevi, and 61.5+ 39.4 in malignant, melanomas. Malignant melanomas showed onger intensity of PCNA staining than the other melanocytir nevi. CONCLUSION: There was not significant difference of the numter of PCNA-positive cells among the groups of congenital neviind PCNA staining can't be used in prditive measure of malignant. progression and studying mechansm of malignancy in giant congenital nevi. But, PCNA staining is considered as an useful method in differentiat,ing malignant melanoma from mllanocytic nevi.
Melanoma ; Nevus ; Nevus, Pigmented ; Prognosis ; Proliferating Cell Nuclear Antigen* ; Skin*

Vasectomy has become increasingly popular as a method of male fertility control in humans because it is simpler than other methods for a woman. In spite of numerous studies on the effects of vasectomy on reproductive organs and their functions over varying periods of time, a lot of problems remained such as histological and functional changes of the reproductive organs. Recently the vasovasostomy has been developed under the requiring of succeeding an offspring or other problems, but it has not proved to be consistently i reliable in reversing previously performed vasectomies. Results in most of the investigations indicate that sperm is present in the ejaculate of 95 per cent of the operated cases. However, pregnancy occurs in only 40 per cent of the partners. It also has been demonstrated that antisperm antibodies occur in the serum of approximately half of the patients who have undergone vasectomy, and the immunologic consequences of vasectomy have been investigated extensively in a variety of laboratory animals and in man, but opinions vary as to whether such antibodies may be responsible for infertility after vasectomy. A second, also less information about phenomenon is formation of antisperm antibodies. Some have postulated that sperm granuloma formation is a mechanism for sensitization of the host to his own sperm, but other have concluded that sperm granuloma formation does not necessarily result in humoral sperm autosensitization. In an attempt to observe the effects of seminal vesiculectomy on structure and function of the testes and epididymides in vasectomized rats, this study was performed. The results as follows: 1. Spermatogenesis in the testicular tissue seems to be much inhibited in vasectomized rats after seminal vesiculectomy. 2. Absorptive activity of the rat epididymides may be accounted to be decreased after seminal vesiculectomy. 3. Sperm granuloma occurred around the epididymides of 90 per cent in the vasectomized rat after seminal vesiculectomy: Large one was measured by 2.5 x 1.5cm., but 50 per cent in the vasectomized rat with large one measured by 1.5 x 0.6cm. in size.
Animals ; Animals, Laboratory ; Antibodies ; Contraception ; Female ; Granuloma ; Humans ; Infertility ; Male ; Pregnancy ; Rats* ; Spermatogenesis ; Spermatozoa ; Testis* ; Vasectomy ; Vasovasostomy

We report a case of secondary anetoderma due to pilomatricoma. A 15-year-old girl presented with a soft, 1.5 × 1.5cm in size, atrophic, pinkish and bulged-out lesion overlying the palpable subcutaneous mass on the left upper arm for several months. Histologic examination revealed the reduced number of dermal elastic fibers overlying a typical pilomatricoma.
Adolescent ; Anetoderma* ; Arm ; Elastic Tissue ; Female ; Humans ; Pilomatrixoma*

We report a case of secondary anetoderma due to pilomatricoma. A 15-year-old girl presented with a soft, 1.5 × 1.5cm in size, atrophic, pinkish and bulged-out lesion overlying the palpable subcutaneous mass on the left upper arm for several months. Histologic examination revealed the reduced number of dermal elastic fibers overlying a typical pilomatricoma.
Adolescent ; Anetoderma* ; Arm ; Elastic Tissue ; Female ; Humans ; Pilomatrixoma*