Giant cell tumor is an uncommon primary bone tumor of young adults with the highest incidence in patients 20 to 40 years of age. These tumors are most frequently found in the metaphyseal-epiphyseal region of the long bones, especially around the knee joint and the distal end of the radius. So the normal life expectancy and an active life style of the patient necessitate a reliable and durable surgical remedy for eradicating the tumor and preserving joint function. Furthermore, these have an unpredictable clinical behavior. Although almost always benign, these tumors are locally agressive and tend to have a high rate of rerurrence, and malignant transfomation is well known to be 6 15%. Thus the lesions produce a practically difficult therapeutic problem for the orthopaedic surgeon, and a satisfactory method of treatment has not yet been found. Clinical observations were carried out on 33 cases of giant cell tumor of bone in the Department of Orthopaedic Surgery, Yonsei University College of Medicine from May 1975 through May 1985, and the following results were obtained. 1. The highest incidence, 23 cases (70%), accurred in the 21 40 year old age group, and the sex distribution was 18 males and 15 females. 2. The most frequent locations were the distal feuiur, proximal tibia and distal radius. Twenty four cases(73%) occurred around the knee joint. 3. The pathologic grading according to Jaffes criteria showed 10 cases(30.3%) in grade I, 20 cases (60.6%) in grade II and 3 cases(9.1%) in grade III. 4. As the primary treatment modality, currettage and bone graft were performed in 9 cases, currettage and bone cementing in 9 cases, amputation or disarticulation in 7 cases, enbloc excision with or without other procedures in 6 cases and currettage and radiotherpy in 2 cases. 5. Eight cases(24.2%) recurred after primary treatment and 6 cases of the 8 recurrences appeared within 2 years after primary treatment. 6. Four of the 9 tumors treated by currettage and bone graft recurred, as did two of the 9 tumors treated by currettage and bone cementing. No recurrence occurred in the 7 tumors treated by amputation or disarticulation. 7. As the secondary treatment modality for 8 recurrences, amputation or disarticulation was performed in 5 cases.
Amputation ; Disarticulation ; Female ; Giant Cell Tumor of Bone ; Giant Cell Tumors ; Giant Cells ; Humans ; Incidence ; Joints ; Knee Joint ; Life Expectancy ; Life Style ; Male ; Methods ; Radius ; Recurrence ; Sex Distribution ; Tibia ; Transplants ; Young Adult

STUDY DESIGN: A retrospective analysis of 166 patients was undertaken to observe radiologically the changes of adjacent segments at follow-up more than three years after lumbar fusion. OBJECTIVES: The purpose of this study is to analyse the changes of adjacent segments and to correlate these changes to the length of using level and to the degree of deviation from physiologic lumbar lordosis. The authors also correlate these radiologic changes to the clinical symptoms. MATERIALS AND METHODS: In simple x-ray, authors observed traction spur, disc space narrowing, endplate sclerosis and vacuum phenomenon of adjacent segments. Authors used Gelb's criteria in segmental lordosis angle(SLA) and Katz's classification in clinical results. RESULTS: The average age was 49.6 years old and the average follow-up period was 57.2 months(4 years and 9.2 months). We observed radiologically the traction spurs in 35 cases(21.1%), end-plate sclerosis in 32 cases(19.3%), disc space narrowing in 33 cases(19.9%) and the vacuum phenomenon in 10 cases(6.0%). The numbers of fusion segments and the degree of unphysiologic segmental lordosis angle in fusion segments were related with the frequency and degree of changes of adjacent segments(P<0.05). The clinical results showed satisfaction in 142 cases(85.5%), unsatisfaction in 24 cases(14.5%) and low back pain in 24 cases(14.5%), leg pain in 11 cases(6.6%) and extension of fusion level in 4 cases(2.4%). In low back pain patients more than two kinds of radiological changes were frequently observed than the patients without low back pain(P<0.05). CONCLUSIONS: The radiological changes of adjacent segments were more frequently observed in long fusion and in fusion with unphysiologic lumbar lordosis angle. And these changes are frequently associated with low back pain. Thus long fusion and fusion with unphysiologic lumbar lordosis angle should be avoided if possible.
Animals ; Classification ; Follow-Up Studies* ; Humans ; Leg ; Lordosis ; Low Back Pain ; Retrospective Studies ; Sclerosis ; Spinal Fusion* ; Traction ; Vacuum

Operative reduction is not essential for mild to moderate spondylolisthesis, but some authors agree that reduction of spondylolisthesis is beneficial for widening of intervertebral canal and consequently for decompression of neural tissue even though the degree of slippage is grade I or II. In our institute, we sometimes reduced the slippage for these reasons. But at follow up study we would find redisplacement and the degree of it seemed to be associated with the kind of instruments. So we analyzed redisplacement rate according to the kind of instruments in 59 cases of spondylolisthesis that were followed more than one year. The conclusions were as follow; 1. There was no significant correlation between reduction and redisplacement rate with pathologic type, lesion site, age,iscectomy and clinical result at least in grade I or II spondylolisthesis (P>0.05). 2. The pedicle screw system was more useful in reduction and its maintenance than the Luque ring system (P<0.001). 3. Redisplacement was occurred mainly within 2 months after operation, 4. The cause of redisplacement after reduction seems to be associated with mechanical insecurity before consolidation of the grafted bone takes place.
Decompression ; Follow-Up Studies ; Spondylolisthesis* ; Transplants

Melanocytic nevus may be histologically associated with clefts or slits of nests, resembling lymphatic or vascular spaces. This unique histologic feature is known as an artifact of injection or tissue processing. The pseudovascular space may resemble the lymphatic invasion of malignant melanoma. Therefore it is important that dermatologists are aware of this histologic variant of melanoctic nevus in order to prevent misdiagnosis. We report three cases of melanocytic nevi with pseudovascular spaces in a 48-year-old, 43-year-old and 44-year-old women. Histologic examination of one case identified a compound melanocytic nevus and two cases identified intradermal nevi. Nevus cell nests were clustered in the dermis or dermoepidermal junction. Vessel-like spaces also were seen in the nevus cell nest. Immunohistochemically, the cells lining the pseudovascular space were positive for S-100 protein, and negative for factor VIII-related antigen and CD31 stain. We concluded that these spaces were lined by nevomelanocytes and were not truly vascular. We herein report on three melanocytic nevi with pseudovascular spaces.
Adult ; Artifacts ; Dermis ; Diagnostic Errors ; Female ; Humans ; Melanoma ; Middle Aged ; Nevus ; Nevus, Intradermal ; Nevus, Pigmented* ; S100 Proteins ; von Willebrand Factor

Acral pseudolymphomatous angiokeratoma of children (APACHE) is a recently recognized, rare clinical entity with only 20 reported cases worldwide. It is characterized by unilateral eruptions of multiple angiomatous papules, mostly on acral areas and mainly in children, although some cases have also been reported with involvement of non-acral areas and occurring in adults. The histopathologic examination revealed diffuse dermal infiltrates of lymphohistiocytes and thick-walled vessels lined with prominent plump endothelial cells. APACHE is a cutaneous pseudolymphoma, rather than a vascular neoplasm, because of distinct histopathologic and immunohistochemical findings. We report a case of a 9-year-old girl who presented with multiple angiomatous papules on her right upper arm. The histopathologic and immunohistochemical findings in our patient were consistent with a diagnosis of APACHE.
Adult ; Angiokeratoma* ; APACHE ; Arm ; Child* ; Diagnosis ; Endothelial Cells ; Female ; Humans ; Pseudolymphoma ; Vascular Neoplasms

Chemotherapy-induced acral erythema (CIAE) is a toxic reaction to a number of different chemotherapeutic agents, and causes symmetrical, well-demarcated, painful erythema on the palms and soles which is self-limiting. CIAE with bullous reaction in relation to methotrexate has been reported, but it is more commonly associated with cytosine arabinoside. The differential diagnosis of this condition from more serious conditions such as graft-vs-host disease or toxic epidermal necrolysis is essential. In this paper, we report the case of a 65-year-old man who developed bullous acral erythema after the administration of high-dose methotrexate for the treatment of Non-Hodgkin's lymphoma.
Aged ; Cytarabine ; Diagnosis, Differential ; Erythema* ; Graft vs Host Disease ; Hand-Foot Syndrome ; Humans ; Lymphoma, Non-Hodgkin ; Methotrexate ; Stevens-Johnson Syndrome

Generalized plane xanthoma is a group of plane xanthomas that appear as yellow to yellowish-brown flat patches or slightly-elevated plaques with a wide-spread distribution. This disease is not common and may occur in hyperlipidemic or nomolipidemic states. Generalized plane xanthoma with normolipidemia is often associated with multiple myeloma, other reticulo-endothelial malignancies and monoclonal gammopathy with unknown siginificance (MGUS). We report a case of generalized plane xanthoma associated with monoclonal gammopathy of unknown siginificance in a 40 year-old man.
Adult ; Humans ; Multiple Myeloma ; Paraproteinemias* ; Xanthomatosis*

No abstract available.
Drug Therapy* ; Pregnancy*

The osteopoikilosis is commonly known as harmatoma in which metaphyseal and epiphyseal area of long bones and the bone of pelvis, hands, feet and et al, contain islands of dense cortical bone with normal Harversian system without any symptoms. The radiologic findings of the osteopoikilosis is multitude of oval or well-circumscribed areas of increased density, 2 to 10 mm in size, in symmetrical distribution and normal uptake in bone scan. Buschke-Ollendorff syndrome, which is transmitted by autosomal dominant, is characterized by the association of osteopoikilosis and connective tissue nevi which are popular and symmetrically distributed lesions on chest, back, buttock, thigh or arm. Authors report three Buschke-Ollendorff syndrome, studied by CT scan, MRI, bone scan and bone and skin biopsy, among five patients associated with osteopoikilosis found by simple radiologic study from ten members in one family with their pedigree.
Arm ; Biopsy ; Buttocks ; Connective Tissue ; Foot ; Hand ; Humans ; Islands ; Magnetic Resonance Imaging ; Nevus ; Osteopoikilosis ; Pedigree ; Pelvis ; Skin ; Thigh ; Thorax ; Tomography, X-Ray Computed

PURPOSE: Femoroacetabular impingement (FAI) is considered an important cause of early degenerative arthritis development. Although three-dimensional (3D) imaging such as computed tomography (CT) and magnetic resonance imaging are considered precise imaging modalities for 3D morphology of FAI, they are associated with several limitations when used in out-patient clinics. The paucity of FAI morphologic data in Koreans makes it difficult to select the most effective radiographical method when screening for general orthopedic problems. We postulate that there might be an individual variation in the distribution of cam deformity in the asymptomatic Korean population. MATERIALS AND METHODS: From January 2011 to December 2015, CT images of the hips of 100 subjects without any history of hip joint ailments were evaluated. A computer program which generates 3D models from CT scans was used to provide sectional images which cross the central axis of the femoral head and neck. Alpha angles were measured in each sectional images. Alpha angles above 55° were regarded as cam deformity. RESULTS: The mean alpha angle was 43.5°, range 34.7–56.1°(3 o'clock); 51.24°, range 39.5–58.8°(2 o'clock); 52.45°, range 43.3–65.5°(1 o'clock); 44.09°, range 36.8–49.8°(12 o'clock); 40.71, range 33.5–45.8°(11 o'clock); and 39.21°, range 34.1–44.6°(10 o'clock). Alpha angle in 1 and 2 o'clock was significantly larger than other locations (P < 0.01). The prevalence of cam deformity was 18.0% and 19.0% in 1 and 2 o'clock, respectively. CONCLUSION: Cam deformity of FAI was observed in 31% of asymptomatic hips. The most common region of cam deformity was antero-superior area of femoral head-neck junction (1 and 2 o'clock).
Adult ; Congenital Abnormalities ; Femoracetabular Impingement ; Femur ; Head ; Hip Joint ; Hip ; Humans ; Magnetic Resonance Imaging ; Mass Screening ; Methods ; Neck ; Orthopedics ; Osteoarthritis ; Outpatients ; Prevalence ; Tomography, X-Ray Computed