No abstract available in English.
Knee Prosthesis ; Knee

Primary angiosarcoma of the female reproductive system is extremely rare, and its management is not well understood. We experienced a very rare case of angiosarcoma arising in the uterus of a 37-year-old woman who presented abdominal distension. At laparotomy, the uterus was observed to be enlarged and deformed by multilobulated hemorrhagic mass. Tumor deposits were present on both ovaries and the omentum. The operation consisted of total abdominal hysterectomy with salpingo-oophorectomy, and omentectomy. Microscopic examination showed that the tumor consisted mostly of solid sheets of pleomorphic and spindle cells forming irregular, communicating cleft-like spaces. Well-formed vascular channels lined by atypical endothelial cells were seen in differentiated areas. Some vessels were partially lined by normal endothelial cells and partially by neoplastic endothelial cells. Papillary architecture composed of epithelioid tumor cells was noted in a focal area. The tumor cells were immunoreactive for factor VIII-related antigen, Ulex europaeus agglutinin-1, CD31 and CD34. Weibel-Palade bodies were not seen in the tumor cells. She received adjuvant chemotherapy, but died 13 months after the diagnosis.
Adult ; Chemotherapy, Adjuvant ; Diagnosis ; Endothelial Cells ; Female ; Hemangiosarcoma* ; Humans ; Hysterectomy ; Laparotomy ; Omentum ; Ovary ; Ulex ; Uterus* ; von Willebrand Factor ; Weibel-Palade Bodies

No abstract available.
Knee* ; Passive Cutaneous Anaphylaxis*

As the number of primary total knee arthroplasties (TKA) have increased, there has been a corresponding increase in the number of revision TKAs. The purpose of the this study is to report on the follow-up results of 50 revision TKAs, and to assess their clinical outcome. From January 1990 to December 1995, 50 revision TKAs were perfomed in 43 patients, by one surgeon. Mean follow up time was 2.5 years (range, 1 to 6 years). The mean interval from the initial arthroplasty to revision was 4.6 years (range, 3 months-12.6 years). The causes of the revision were wear of polyethylene in 29 joints (58%), infection in seven (14%) and aseptic loosening in six. The revision components were fixed with cement in all cases. Additional fixations were obtained with modular stems (femoral 11 cases, tibial 13 cases), 9 tibial metal wedges, 7 femoral augmentations, and 12 allografts. The Knee Rating Scale of Hospital for Special Surgery was used for clinical assessment. The mean flexion contracture and further flexion of knee joint were 8.8degrees (range, 0-70degrees), 98.5degrees (range, 5-135degrees) preoperatively, and 3.7degrees (range, 0-15degrees), 112degrees (range, 75-135degrees) postoperatively. The Knee Rating Scale improved from 66.5 points (range, 15-83) to 87.5 points (range, 79-98). There were two cases of complications, dislocation of patella and superficial wound problem in each case. In conclusion, wear was the most common cause of failure of primary TKA. The results of revision in infected TKA were less favorable than that of wear and loosening. The prosthetic design and thickness of polyethylene were the most important factors related to wear. The tibial component of PCA and patellar component of Miller-Galante had significant wear problems.
Allografts ; Arthroplasty* ; Contracture ; Dislocations ; Follow-Up Studies ; Humans ; Joints ; Knee Joint ; Knee* ; Passive Cutaneous Anaphylaxis ; Patella ; Polyethylene ; Wounds and Injuries

Historically, cerclage has gained a bad reputation because of the early unfavorable results with the Parham band and subsequent further poor results with wire cerclage. The treatment and management of elderly patients with fractures through osteoporotic bone is fraught with difficulties. The standard methods of internal fixation are not always satisfactory as metal plates and screws and intramedullary nailing do not hold well in osteoporotic bone. To overcome this problem, a system of straps and plates has been devised. We experienced 3 cases of femoral fractures using nylon cerclage system, such as the segmental fracture, oblique fracture in osteoporotic patient and the fracture below a hip prostesis. The end-result was satisfactory.
Aged ; Femoral Fractures ; Femur ; Fracture Fixation, Intramedullary ; Hip ; Humans ; Nylons

It was reported that many adverse effects occurred to the growth areas of the adolescent player due to repititous strain. The injuries mainly involved in the shoulder and elbow, and named as little leaguers Shoulder and Little Leaguers: Elbow in boy baseball player. But the stress fracture of olecranon epiphyseal plate was rare and reported in a few cases. We reported a case observed in an adolescent Judo Player.
Adolescent ; Baseball ; Elbow ; Fractures, Stress ; Growth Plate ; Humans ; Male ; Martial Arts ; Olecranon Process ; Shoulder

There are many controversies in ability of articular cartilage to heal full thickness defect. Generally, it is reported that full thickness defects of articular cartilage filled with organizing hematoma and granulation tissues, which converted to chondroid tissues. It is clear that the size of defect was related to the repair of articular cartilage. Though cartilagenous material fills the defect and restores the surface continuity, it may undergo degeneration, and lead to localized focus of osteoarthritis. Multiple drilling through subchondral bone could be a kind of treatment in articular cartilage defect. Author conducted an experiment for the full thickness defect of articular cartilage in rabbit. After multiple drilling of articular cartilage, the repair of defect was examined histologically until eighth week. Results were as followings ; l. At lst. week, the defect was repaired by fibrovascular proliferation and granulation tissue. 2. At 3rd. week, hyaline cartilage consisted of normal chondrocyte was formed. 3. At 8th. week, subchondral plste was regenerated completely. 4. All defects that were less than 3 mm. in diameter were healed. More repairs were observed in case with the wider defects if the defects were within 3mm. in diameter. 5. The metachromasia was observed with toluidine blue stain. The reformed cartilage shows slight purple(Grade II) to moderate purple(Grade III) at third week and near normal (Grade IV) at fourth week. In conclusion, multiple drilling may be an effective method of treatment in articular cartilage defect. It is considered that multiple drilling with a 3mm. Steinmann pin may be the most convenient and effective method of the cartilage healing.
Cartilage ; Cartilage, Articular ; Chondrocytes ; Granulation Tissue ; Hematoma ; Hyaline Cartilage ; Methods ; Osteoarthritis ; Regeneration ; Tolonium Chloride

Partial knee ankylosis is a recognized complication following open operative procedure, trauma and disease processes about the knee. It can result from the formation of intraarticular adhesion and contracture of the capsule as well as the shortening or adhesion of the quadriceps mechanism. Physical therspy and occasionally manipulation under the anesthesia may improve the results, but performed late, these methods will be useless. This is a review of 30 patients who had severe limitation of motion in the knee joint following open operative procedures or trauma about the knee and who were treated by the percutaneous release of adhesions under the arthroscopic control. The following results were obtained; There were 17 males and 13 females, and the age of release ranged from 23 to 69 years old (av. 42.8years old). The interval between arthroscopic adhesiolysis and the last follow-up evaluation ranged from 6 months to 5 years and 7 months(av. 23 months). The interval between the last open operative procedure or trauma and arthroscopic adhesiolysis ranged from 3 months to 4 years(av. 15 months). The average preoperative knee ROM was 38.8°the postoperative ROM was 121.1°and the average final knee ROM at follow-up was 102.6°So the average loss of ROM was 18.5°The arthroscopic adhesiolysis seems to be applied to the various conditions of the partial knee ankylosis and the results are better than the other surgical procedures when it was performed early enough.
Anesthesia ; Ankylosis ; Contracture ; Female ; Follow-Up Studies ; Humans ; Knee Joint ; Knee ; Male ; Surgical Procedures, Operative

OBJECTIVE: Endometriosis is a disease affecting a large population of women all over the world. A local sterile inflammation occurs in the peritonel cavity of patients with endometriosis. It suggests that immunological events play a major role in the pathogenesis of endometriosis. We have studied the levels of serveral T cell and monocyte derived cytokines, especially IL-6 (promoter of immune response) and IL-10 (inhibitor of immune response), in the peritoneal fluid of patients with endometriosis to characterize the change of immune response that occurs at the site of endometriosis. Method: This study was performed in Hallym university hospital from October, 1997 to October 1998 and enrolled 29 women with gross or microscopic findings of minimal to severe endometriosis in case group, and 28 women without visual evidence of pelvic endometriosis and with benign gynecologic disease in control group. IL-6 and IL-10 levels in the peritoneal fluid were determined using commercial ELISA and compared between endometriosis and controls and between fertile and infertile women with endometriosis and according to the revised American Fertility Society classification. RESULT: IL-6 was higher and IL-10 was lower in the peritoneal fluid of endometriosis group than of control group. Cyclic variations in the IL-6 concentrations were seen in endometriosis group : the concentrations in the secretory phase were significantly higher than those in the proliferative phase. In endometriosis group, IL-6 concentrations of infertile women were higher than fertile women. Both IL-6 and IL-10 in the peritoneal fluid of endomtriosis group did not show significant correlation according to r-AFS stages. CONCLUSION: Increased IL-6 and decreased IL-10 levels in the peritoneal fluid may be related to infertility and pathogenesis in the endometriosis, suggesting that partially contribute to the disturbed immune regulation observed in endometriosis.
Ascitic Fluid* ; Classification ; Cytokines ; Endometriosis* ; Enzyme-Linked Immunosorbent Assay ; Female ; Fertility ; Genital Diseases, Female ; Humans ; Infertility ; Inflammation ; Interleukin-10* ; Interleukin-6* ; Monocytes

PURPOSE: To evaluate further the right minor and major fissure on thin-section narrow-interval CT scans with particular emphases on orientation, degree of completeness. MATERIALS AND METHODS: Thin section CT scans from 10 mm distal to carina to the proximal basal segmental bronchus were obtained at 5 mm invervals in 50 consectutive subjects. Orientation, degree of completeness, and the relationship of the minor and major fissure on thin-section CTscans were analyzed. RESULTS: Four principal types of the minor fissure could be identified according to the highest point of the upper surface of the middle lobe. At bronchus intermedius level, the major fissure appeared with its medial end anterior to lateral end in 45 subjects. The minor fissure was complete in only 10 subjects (20%). Completely absent minor fissure was noted in four subjects (8%). The major fissure was incomplete in 17 subjects (34%) at bronchus intermedius level. the minor and major fissure intersected each other in only 27 subjects (54%). The hig best point of intersection was variable. CONCLUSION: There are much more variations in the fissural complex in our study than in previous reports and these variations can be visualized well on thin-section CTscans.
Bronchi ; Lung* ; Tomography, X-Ray Computed*