Lipoma arborescens is a rare intra-articular lesion consisting of a villous lipomatous proliferation of the synovial lining. We experienced one case of lipoma arborescens of knee which was associated with avascular necrosis of femoral head. This case report draws the attention to history, physical findings, MR images, pathologic findings and arthroscopic appearance of this rare lesion. Arthro;copically, the lesion appears as a synovial lesion with numerous fatty-appearing globules and villous projections. Although the etiology is unknown, lipoma arborescens has been described in association with osteoarthritis, rheumatoid arthritis and diabetes mellitus. MR imaging is diagnostic choice to differentiate the lesion from rheumatoid arthritis, pigmented villonodular synovitis and synovial chondromatosis in those patients who present with chronic, swollen and painfui joint. Arthroscopic removal was effective in this case and we think that treatment choice of this lesion is arthroscopic removal.
Arthritis, Rheumatoid ; Chondromatosis, Synovial ; Diabetes Mellitus ; Head ; Humans ; Joints ; Knee* ; Lipoma* ; Magnetic Resonance Imaging ; Necrosis ; Osteoarthritis ; Synovitis, Pigmented Villonodular

No abstract available.
Sertoli-Leydig Cell Tumor*

No abstract available.

Legg-Calve-Perthes disease (LCP) has been reported to be associated with hypofibrinolysis and a deficiency in coagulation. The goal of this prospective study was to confirm or refute these findings and to establish a guide for a screening test. The coagulation systems of twenty-three patients with Legg-Calve-Perthes disease were evaluated by means of the tests which included prothrombin time, activated partial thromboplastin time, antithrombin-III (AT-III), protein C, protein S, lipoprotein(a), and anticardiolipin antibody (ACA). Study subjects were 21 males and 2 females. Mean age was 8.7 years. No abnormal results were found for Antithrombin-III and Protein S, but 2 patients had low Protein C level. Two of 23 patients had Lipoprotein(a) values greater than 30 mg/dl. Another two patients had positive finding for Anticardiolipin antibody. There were no statistical differences in all parameters between Catterall group stage in the patients with Legg-Calve-Perthes disease. We were unable to establish an association between thrombotic tendency and Legg-Calve-Perthes disease based on this prospective study. So, routine screening of patients with Legg-Calve-Perthes disease for abnormalities of antithrombotic factors would be not warranted.
Antibodies, Anticardiolipin ; Female ; Humans ; Legg-Calve-Perthes Disease* ; Lipoprotein(a) ; Male ; Mass Screening ; Partial Thromboplastin Time ; Prospective Studies ; Protein C ; Protein S ; Prothrombin Time

Teriparatide (TPTD) is a bone-forming agent used to treat postmenopausal osteoporosis. Since hip fractures are related to higher morbidity and mortality rates than other fractures, efficacious osteoporosis drugs for the hip are critical. We reviewed research articles reporting the efficacy of TPTD in terms of bone mineral density (BMD), fractures prevention, changes in the outer diameter, cortical thickness and porosity, post-operative periprosthetic BMD loss, and healing of typical and atypical fractures of the hip. Data meta-analyses indicated that TPTD not only increased the BMD of the proximal femur but also decreased the risk of hip fractures. Even though TPTD increases the cortical bone porosity of the proximal femur, the bone strength does not decrease as the majority of the porosity is located at the endocortex; further, it increases the outer diameter and thickens the cortical bone.TPTD stimulates bone remodeling and facilitates callus maturity and fracture healing. There have been many reports on improving the effect of TPTD on the healing of atypical fractures; therefore it is advisable to use TPTD considering the increase benefit compared to the risk.

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

PURPOSE: To evaluate morphologic characteristics of the microcalcifications on mammography that were confirmed pathologically. MATERIALS AND METHODS: Forty five cases of microcalcifications on mammography (fifteen cases of benign lesion, thirty cases of maiignancy) were retrospectively reviewed. RESULTS: The number of microcalcifications within 1 cm2 were more than 5 in 22 cases (73%) of 30 malignancy and less than 5 in 11 cases (73%) of 15 benignity. The heterogeneity of microcalcifications were seen in 26 cases of malignancy (87%) and the homogeneity of microcaicifications were 11 cases of benignity (73%). The morphologic characteristics of the microcalcifications were linear-V shape in 9 cases (30%), punctate shape in 8 cases (27%), fine stippled shape in 7 cases (23%), and round dot shape in 6 cases (20%) of malignancy and, round dot shape in 11 cases (73%), punctate shape in 2 cases (13%), and linear-V shape in 2 cases (13%) of benignity. CONCLUSION: Numerous irregular microcalcifications that are heterogenous in size and morphology were strong indicators of malignancy.
Mammography ; Population Characteristics ; Retrospective Studies

Falls are the most common cause of accidents among the older population, leading to both fatal and non-fatal injuries. Falls is a syndrome resulting from the cumulative effect of various extrinsic and intrinsic factors. It is considered to be a multifactorial disorder. Medication use is considered a risk factor for falls. We reviewed medications associated with falls in older individuals. In geriatrics populations, polypharmacy is associated with falls. Medical doctors should be aware of the possibility that starting a new medication, such as antihypertensive agents, benzodiazepine, antidepressants, opioid agents and antihistamines, may act as a trigger for the onset of a fall.
Accidental Falls ; Antidepressive Agents ; Antihypertensive Agents ; Benzodiazepines ; Geriatrics ; Histamine Antagonists ; Intrinsic Factor ; Polypharmacy ; Risk Factors

The Fracture of the os calcis is quite common in relation to fracture in other tarsal bone, and fractures involving the subtalar joint may cause serious and persistant disabilities. The treatment of these calcaneal fractures remains controversial So there is no universal agreement in the treatment of these fractures, especially involving the subtalar joint. Twenty displaced intraarticular fractures of calcaneus in 15 patients were treated by open reduction and internal fixation with a plate and screws and bone graft through a lateral approach to elevate the depressed lateral portion of the posterior facet at the Inchon Chritian Hospital from Jan., 1990 to Dec, 1991. Twenty feet in 15 patients of calcaneal fractures involving the subtalal joint were treated and were clinically analysed and following result were obtained. 1. The 20 cases were classified according to the Sanders classification, 9 in type II, 9 in type III and 2 in type IV. 2. The 20 cases were treated by open reduction andinteranl fixation with plate and screws and iliac bone graft through an Sanders lateral approach. The bone graft is packed under the elevated posterior to prevent late collapse of the central fragment and to supply structral stability. 3. The preoperative average Böhler's angle was 0.4°. The post operative average Böhler's angle was 23.4° which was increased significantly. 4. Based on assessment of result of Salama, excellenwas 6, good was 7, fair was 4 and poor was 3. 5. The most common complication after treatment was persistant pain, especially beneath the lateral malleolus.
Calcaneus ; Classification ; Foot ; Humans ; Incheon ; Intra-Articular Fractures ; Joints ; Subtalar Joint ; Tarsal Bones ; Transplants

Because of congenital deficiency of the superior sacral facet of S1 or the arch of L5 in dysplastic spondylolisthesis, progression of slippage may occur even in the presence of a posterior solid arthrodesis, especially in the patients with high degree of slippage and lumbosacral kyphsis. Therefore, the anterior interbody fusion may be necessary additionally. But the operation is very difficult because of a little supporting structure anteriorly for bone grafting. We have a case of dysplastic spondylolisthesis which showed progressive slippage even though solid posterolateral fusion. On which case we performed additional anterior interbody fsuion by the technique of anterior open wedge osteotomy on the superior dome of sacrum to support the L5 on S1. And this is the case report of the result.
Arthrodesis ; Bone Transplantation ; Humans ; Osteotomy ; Sacrum ; Spondylolisthesis