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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.

PURPOSE:The prevalence of childhood obesity has been increased rapidly, associated with high morbidity of dyslipidemia, cardiovascular risk factors and insulin resistance/hyperinsulinemia. Hyperinsulinemia in obese children may depend on either increased insulin secretion or decreased insulin clearance. We investigate whether insulin secretion and clearance are different between obese and normal weight children. METHODS:The body mass index(BMI), fasting serum glucose, insulin and C-peptide levels were measured in 101 children(52 obese children and 49 non-obese controls) in Ansan area, from 6 to 14 years old. Fasting serum C-peptide/insulin ratio, insulin/glucose ratio, homeostasis model assessment(HOMA) were calculated and compared between obese and control group. RESULTS:The fasting serum insulin and C-peptide levels were significantly higher in obese group than in controls. The C-peptide/insulin ratio was significantly lower and insulin/glucose ratio was significantly higher in obese group than in controls. There were positive correlations between BMI and fasting serum insulin level, fasting insulin/glucose ratio and HOMA. The prevalence of hyperinsulinemia is higher in obese adolescents than in controls. CONCLUSION: Our findings suggest that increased insulin secretion and decreased insulin clearance may contribute to hyperinsulinemia in obese children.
Adolescent ; Blood Glucose* ; C-Peptide* ; Child* ; Dyslipidemias ; Fasting* ; Gyeonggi-do ; Homeostasis ; Humans ; Hyperinsulinism ; Insulin* ; Obesity* ; Pediatric Obesity ; Prevalence ; Risk Factors

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

Perifollicular fibromas are very undsual adnexal tumor of the skin. Clinically, they are small firm akin colored or pinkish papules and usually located on the face and neck. We report a case of perifollicular fibroma which occurred in a 30-year-old woman, who had asymptomatic multiple small skin colored papules on the right side of her face for about 20 years. On physical examination, the papules were ferm and non-tender. The biopsy specimen demonstrated concentric proliferation of fibrous tissue surrounding hair follicles ad the collagen fibers within concentric fibrous sheaths surrounding hair follicles stained green with Masson's trichrome stain, which were quite typical for perifollicular fibroma. Because we could not find any epithelial proliferation in the serial sections, fibrofolliculoma could be ruled out. The skin lesions were removed by electrodesiccation and followed up for 5 months without recurrence.
Adult ; Biopsy ; Collagen ; Female ; Fibroma* ; Hair Follicle ; Humans ; Neck ; Physical Examination ; Recurrence ; Skin

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

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*

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*