Pseudallescheria (P.) boydii is a true fungus that is ubiquitous in nature, and has a world-wide distribution. It has been isolated from soil, plant debris, polluted water and sewage. Infection may occur via direct inoculation or inhalation, and usually affects the extremities. It is a common cause of mycetoma characterized by tumefaction, draining sinuses and grains. It has polymorphism due to a complicated life cycle which undergoes teleomorph as well as anamorph stages. Cleistothecia, ascocarp and ascospore may be seen during the teleomorph stages, whereas scedosporium and graphium type may be seen during the anamorph stages. We report a case of P. boydii mycetoma occurring in a 69-year old male. He had multiple nodules with a discharging fistula on a dark red plaque at the dorsum of the right forearm. Cultural isolation for definitive diagnosis showed typical P. boydii. The lesion responded well to daily itraconazole.
Aged ; Edible Grain ; Diagnosis ; Extremities ; Fistula ; Forearm ; Fungi ; Humans ; Inhalation ; Itraconazole ; Life Cycle Stages ; Male ; Mycetoma* ; Plants ; Pseudallescheria* ; Scedosporium ; Sewage ; Soil

Paraffinoma is a well known complication of previous paraffin injection into the subcutaneous layer that presents as various conditions including firm mass formation, edema, induration, ulceration, and skin necrosis. Paraffinoma can mimic neoplasm on physical examination and imaging studies and may complicate ultrasonographic diagnoses due to typical posterior shadowing and high echogenicity. When paraffinomas involve around the thyroid gland, the diagnosis of thyroid tumors is very difficult. We present a case of thyroid cancer, the evaluation of which was complicated by the presence of cervical paraffinoma.
Edema ; Hydrazines ; Necrosis ; Paraffin ; Physical Examination ; Shadowing (Histology) ; Skin ; Thyroid Gland ; Thyroid Neoplasms ; Ulcer

Platelet-derived growth factor(PDGF) is known to accelerate soft tissue fracture and periodontal bone healing, but little information is available for characterizing the healing of articualr cartilage. This study was designed to demonstrate the regeneration potential of pasteurized autogeneous osteochondral graft when PDFG was applied locally in vivo. Eighteen rabbits in two groups were used in the experiment. The free osteochondral fragment(1x1x1 cm) were taken from distal femur. The fragment were pasteurized in 65degrees C for 5 minutes. In experimental group(group II), the fragment were soaked in 0.25 mg/ml of recombinant human PDGF mixed 5 ml normal saline and reimplanted to the resected site, and followed with local administration of 0.25 mg/ml PDGF to knee joint. In control group(group I), the pasteurized fragment were reimplanted in the resected site without any treatments. The histologic characteristics of the transplanted autografts for three rabbits in each group were observed at 3, 5 and 7 weeks postoperatively. The results were as follows; Group II revealed the more favorable regeneration of articular cartilage, less arthritic changes and more mature arrangement of chondrocytes than group I. Even thought the cartilage is avascular and the regeneration capacity of pasteurized cartilage is severely limited, the regeneration of grafted articular cartilage is thought to be accellerated by increased newly formed blood vessels and soft tissues due to the diffusion of PDGF on grafted cartilage, and probably also by differentiation of mesenchymal cells in the initial stage of experiment. The results of this study suggest that local administration of PDGF could be used for the treatment of posttraumatic or degenerative arthritis and various cartilage damages.
Autografts ; Blood Vessels ; Cartilage ; Cartilage, Articular ; Chondrocytes ; Diffusion ; Femur ; Humans ; Knee Joint ; Osteoarthritis ; Platelet-Derived Growth Factor* ; Rabbits* ; Regeneration* ; Transplants*

No abstract available.
Osteoporosis* ; Radionuclide Imaging*

OBJECTIVE: In accordance with the increasing number of elderly people in our society, the incidence of pedicle screw fixation which is a technically demanding procedure and requires a lengthy operation time has increased in the patients with lumbars instability over 60 years old. To ascertain the outcome and efficacy of the pedicle screw fixation in patients over 60 years old, we analyzed the surgical results including complications. PATIENTS AND METHOD: From May, 1994 to September, 1997, we assessed 30 patients over 60 years of age and 159 patients under the age of 60 with lumbar spinal instability who underwent surgery of pedicle screw fixation and compared with the results of surgery between two groups. RESULTS: For the elderly, the average operation time was 244 minutes and the transfusion amount was 3.3 pints. For younger patient the average operation time was 246 minutes and the transfusion amount was 3.2 pints. Four surgical complications occurred; two patients with voiding difficulty, one patient with heart problem, and a patient with DIC(Disseminated Intravascular Coagulation). However, all complications were controlled without further problems. The success rate in the elderly was 60%, which was lower than the success rate of 76% among younger patients. CONCLUSION: Considering the condition of the diseases in the elderly and the fact that the operations were performed without any major problems, these results are acceptable. Based on our analysis, it is our view that advanced age per se should not be regarded as a contraindication for pedicle screw fixation.
Aged ; Follow-Up Studies* ; Heart ; Humans ; Incidence ; Middle Aged*

No abstract available.
Humans

Intertrochanteric fractures are common in older age group. Recently better implant design and surgical technique have improved clinical results. But still many patients suffer from high morbidity and mortality, because of accompanying osteoporosis and various senile diseases. From January 1991 to June 1994, we treated 54 patients older than 70 years with intertrochanteric fractures of femur. Among them, 23 patients were followed up at our hospital and the other patients were informed from police station. Lost follow up was ten patients and final follow up were 44 patients. Mortality was analyzed for the detection of causative factors, such as age, sex, associated medical problems. type of fracture, degree of osteoporosis, type of operation, internal between injury and operation and duration of admission. The results were as follows; 1. 26 patients survived and 18 patients died(Mortality rate :40.9%) 2. 10 patients died within 1 year(Mortality rate :22.7%) 3. Mortality was related to associated medical problems, interval between in jury and operation and type of fracture, which were statistically significant(P < 0.05).
Aged ; Femur ; Follow-Up Studies ; Hip Fractures ; Humans ; Mortality ; Osteoporosis ; Police

Tuberculosis of the thyroid gland is extremely rare with few cases reported in recent years. Tuberculosis may involve the thyroid gland in two main forms. The more common of theses is miliary spread to the thyroid as part of generalized dissemination and less commonly focal or caseous tuberculosis of the thyroid may occur, presenting as a nodule, as a thyroiditis, as a abscess, or as carcinoma like.We experienced two cases of tuberculosis of the thyroid gland presenting with palpable thyroid nodule in 26 year-old female and 65 year-old female patients. They have been clinically and biochemically euthyroid and their thyroid scans demonstrated a cold nodule at right thyroid gland. We found no evidence of tuberculosis elsewhere. The goiter was removed surgically and confirmed to be tuberculosis. They were medicated antituberculous agents after operation and followed up regulary out patient department.We report the cases of two patients with tuberculosis involving thyroid with reviews of literature.
Abscess ; Female ; Goiter ; Humans ; Thyroid Gland ; Thyroid Nodule ; Thyroiditis ; Tuberculosis

PURPOSE: Human adipose tissue-derived mesenchymal stem cells(hATSCs) can be differentiated into multiple mesenchymal lineages, including bone, cartilage, and muscle. And growth hormone play important roles in the normal growth and development of the CNS. In this study, we explored whether the transplanted hATSCs and growth hormones could improve functional recoveries from rats with contusive spinal cord injury. METHODS: We divided 30 female rats, which were subjected to a weight driven implant spinal cord injury, into 3 groups with 10 rats each; Group A as a control group, group B with hATSCs transplantation on injured region, and group C with hATSCs transplantation and GH administration for 7 days. Then, we researched their neurologic functional recoveries before and 2, 4, and 8 weeks after transplantation using Basso-Beattie-Bresnahan (BBB) locomotor rating scale. And we checked Y- chromosome positive cells by FISH(Fluorescent in situ hybridization) to identify the survival of transplanted mesenchymal stem cells. RESULTS: After 4 weeks of transplantation, the group B and group C showed significant improvement of neurologic function on BBB locomotor rating scale in comparison with the group A(Group A: 13.1+/-0.58, Group B: 14.6+/-0.69, Group C: 14.9+/-0.56). Moreover, the group C displayed meaningful recovery of neurologic function after 8 weeks in comparison with group B (Group B: 15.7+/-0.63, Group C: 16.5+/-1.14). The group A, the control one, improved for 5 weeks after injury, and had no more recovery. On the other hand, Group B and C showed the improvement of neurologic function continuously for 9 weeks after injury. CONCLUSION: In this study, we found out that hATSCs transplantation have an effect on neurologic functional recovery of spinal cord injured rat and GH injection seems to bring the synergistic results on this good tendency.
Adipose Tissue ; Animals ; Cartilage ; Female ; Growth and Development ; Growth Hormone ; Hand ; Humans ; Mesenchymal Stromal Cells ; Muscles ; Rats ; Spinal Cord ; Spinal Cord Injuries ; Transplants

Amylase-producing multiple myeloma is a rare disorder and has poor prognosis. Its characteristics are elevation of salivary type amylase, extensive extramedullary spread, extensive bone destruction, shorter survival time, and abnormal karyotype. Recently, we have experienced a case of amylase-producing IgG kappa type multiple myeloma in a 63-year-old woman. On admission, serum and urine amylase was 8,450U/L and 169,710U/L, 85% and 86% of which was determined to be the salivary type, respectively. The other cause of hyperamylasemia had not been detected. The presence of immunoglobulin and amylase in the myeloma cells was demonstrated immunohistochemically. Bone marrow aspiration smear revealed 59.1% plasma cells. The cytogenetic study of bone marrow cell showed normal karyotype. The patient died 3 months after chemotherapy with melphalan and prednisolone.
Abnormal Karyotype ; Amylases ; Bone Marrow ; Bone Marrow Cells ; Cytogenetics ; Drug Therapy ; Female ; Humans ; Hyperamylasemia ; Immunoglobulin G* ; Immunoglobulins ; Karyotype ; Melphalan ; Middle Aged ; Multiple Myeloma* ; Plasma Cells ; Prednisolone ; Prognosis