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Arthroscopic Treatment for the Pigmented Villonodular Synovitis in the Knee (슬관절에 발생한 색소 융모 결절성 활액막염의 관절경적 치료)

  • Bae, Dae-Kyung;Cho, Nam-Su
    • Journal of the Korean Arthroscopy Society
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    • v.5 no.1
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    • pp.22-26
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    • 2001
  • Purpose : To confirm the efficacy of arthroscopic synovectomy fur the pigmented villonodular synovitis in the knee. Materials and Methods : Between October 1996 and February 2000, the arthroscopic synovectomy had been performed in six patients(six knee joints), whose diagnoses were confirmed by pathologist. All patients complained of painful swelling in involved knee and four of the six patients had trauma history. There were three male and three female patients. Average age was 35.8 years ranging from 16 to 67 years. Follow up period was average 22.7 months(range, $13\~53$ months). Results : According to arthroscopic findings, there were three localized forms and three diffuse forms. At their last follow-up examinations, all patients had improvement in pain, swelling and range of motion and there was no evidence of recurrence. Conclusion : Complete arthroscopic excision is the definitive treatment for localized pigmented villonodular synovitis and meticulous arthroscopic excision through all portals including posterior portal can be considered as a valid alternative to traditional open synovectomy for the patients with diffuse pigmented villonodular synovitis.

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Clinicostatistical Analysis for 53 Cases which were performed Microlaryngeal Surgery under Suspension Laryngoscope (Suspension Laryngoscope 하에 후두미세 수술을 시행한 53명에 대한 임상통계학적 고찰)

  • 전하동;최인환;추광철;김선곤
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1979.05a
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    • pp.6.3-7
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    • 1979
  • During last two. decades, microlaryngeal surgery opened now era in the laryngeal surgery. In 1960, using Lynch's suspension laryngoscope, Seal co et al performed the first successful microsurgery in the treatment of polyp and other laryngeal diseases. In 1968, Kleinsasser reported a new technique of microlaryngeal surgery with a self retaining laryngoscope. Authors studied the statistic analysis of 53 cases (75 times) of the suspension laryngoscopic microsurgery at E.N.T. department of Han Yang University Hospital from May 1972 to April 1979 an reported this result. 1) sex distribution was male 1.3 : female 1. 2) age distribution was 3rd decade 14 cases (26.4%), 2nd decade 10 cases (18.7%) and 5th decade 9 cases (17%) in order. 3) chief compliant was hoarseness 48 cases (90.6%), dyspnea 16 cases (30.5%) and sore throat 8 cases (15.1%) in order. 4) diagnostic impression was polyp 18 cases (34%), nodule 12 cases (22.6%), papilloma 9 cases (17%), tumor 7 cases (13.2%), intubation granuloma 3 cases (5.7%) in order and other kinds were laryngeal stenosis with decannulation difficulty, laryngeal paralysis and hematoma. 5) histopathologic result of 48 cases was polyp 17 cases (35.4%), papilloma 11 cases (23%), nodule 9 cases (18.9%), malignancy 3 cases (6.3%), chronic inflammation 2 cases (4.2%) in order and others were hyperkeratosis, mucous retension cyst, nodule associated abscess, granuloma, hematoma and unconfirmed case. 6) in involved site, both sides 15 cases (60%), Lt.side 5 cases (19%), Rt side 3 cases (12%), anterior commissure 3 cases (12%) on the nodule and polyp (26 cases) and whole laryngeal involvement 7 cases (63.6%), one side cord involement 3 cases (23.7%), extralaryngeal involvement 1 cases (9.1%) on the papilloma (11 cases).

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KAPOSI'S SARCOMA OF MAXILLARAY GINGIVA IN SYSTEMIC LUPUS ERYTHEMATOSUS (전신성 홍반성 낭창 환자에서 상악 치은에 발생한 Kaposi's Sarcoma)

  • Kim, Il-Kyu;Cho, Hyun-Young;Chang, Keum-Soo;Park, Seung-Hoon;Park, Jong-Won;Sasikala, Balaraman;Kim, Joon-Mee
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.31 no.4
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    • pp.343-348
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    • 2009
  • Kaposi's sarcoma was first descrided by Kaposi in 1872 as an idiopathic multiple hemorrhagic sarcoma. Its clinical features revealed to be erythematous red or purple macule started out, and developing into palpable dome-shaped nodules. Etiology is not defined to detail at present. Kaposi's sarcoma is classified to 4 categories; Classical, African, Epidemic and Immunosuppressive type. Epidemic categories is found approximately 20% of all AIDS patients and has strong predilection for head and neck region. The first case of immunosuppresive type Kaposi's sarcoma in patients with kidney transplants was reported in 1969. Kaposi's sarcoma accounts for 5% of all tumors associated with transplanted patients. The most common site of Kaposi's sarcoma in immunosuppressed patients are extremities, but rare in head and neck area. A 42 years old woman who had systemic lupus erythematosus visited to our clinic because of gingival hyperplasia, and excisional biopsy revealed Kaposi's sarcoma. We experienced a case of favorable results using excision and chemotherapy, so we report with review of literatures.

Calcifying Aponeurotic Fibroma - A Case Report - (석회화 건막 섬유종 - 증례 보고 -)

  • Paik, Seung-Sam;Jang, Ki-Seok;Han, Hong Xiu;Kim, Hyung-Jong;Roh, Won-Il;Lee, Seong-Pil;Lee, Kwang-Hyun
    • The Journal of the Korean bone and joint tumor society
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    • v.9 no.2
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    • pp.233-237
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    • 2003
  • Calcifying aponeurotic fibroma is a benign, aggressive fibrous tumor seen in childhood or adolescence that most commonly affects the palm. We report our experience in treating calcifying aponeurotic fibroma in the hand of fifteen-year-old boy. He was presented with a recurrent mass in hypothenar area of his left hand. He had a history of local excision of the mass 7 years ago in local clinic. The palpable mass was hard, tender and movable. The simple X-ray revealed multifocally scattered microcalcifications in the mass. The excised mass showed the features of dense fibrotic soft tissue tumor with multiple small whitish calcifications. The microscopic sections showed a lobulated and a poorly circumscribed proliferation of dense fibrous tissue, containing islands of metaplastic chondroid differentiation with prominent calcification. The recommended treatment of this lesion is wide excision allowing for sparing of functional or vital structures, but high recurrence rate as this case has been reported to be more than 50 percent.

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Therapeutic Outcome and Recurrence Rate of Helicobacter pylori Infection in Children (소아에서 Helicobacter pylori 감염에 대한 치료결과 및 재발률)

  • Choi, Won-Jun;Kim, Je-Woo;Chung, Ki-Sup
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.1 no.1
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    • pp.37-44
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    • 1998
  • Purpose: This study aimed at evaluating the therapeutic outcome, cost effectiveness and recurrence rate in children with H. pylori infection after the treatment using various medications. Methods: Seventy five children (mean age $11.4{\pm}2.5$ years) were given an endoscopy with biopsy and H. pylori status assessed by CLO test and histologic examination (Warthin Starry stain). Children were given one of following medications such as DA ($Denol^{(R)}$ and amoxycillin), OA (omeprazole and amoxycillin), DC ($Denol^{(R)}$ and clarithromycin) as primary treatment. And one of following medications such as DAM ($Denol^{(R)}$, amoxycillin and metronidazole), DC, OA, OC (omeprazole and clarithromycin) were used in children who failed the eradication of H. pylori. Results: The endoscopic diagnoses were: nodular gastritis (46 cases), gastric ulcer (9), duodenal ulcer (6), superficial gastritis (6), and normal (8). H. pylori eradication rate was 91% (63 of 69 children) on 4 weeks course of DA, 50% (1 of 2 cases who had treatment failure on DA) on DAM, and 75% (3 of 4 cases who treated on DC primarily) and 50% (1 of 2 cases who had treatment failure on DA) on DC, and 100% on OA (all of 2) and on OC (all of 1 who failed on DA). In 3 of 7 children in whom H. pylori had not been eradicated by primary medications (DA 6 and DC 1 case), H. pylori was re-eradicated by secondary medications (DA 1, DAM 1 and DC 1 case). But in remaining 4 cases, H. pylori infection persisted. Reinfection of H. pylori was found in 4 of 75 children between 3 months and 3 years after completion of the treatment of DA, yielding recurrence rate of 5.3%. In 2 of 4 cases who had relapsed, H. pylori was re-eradicated by secondary medications (OC 1 and DA 1 case). But in remaining 2 cases, H. pylori infection persisted. Conclusion: These results suggest that dual therapy with $Denol^{(R)}$ and amoxycillin is the effective medications in treating H. pylori infection in children. Concerning the cost effectiveness, it can be recommended as first line treatment of choice as well.

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The Effects of Intravenous Methylprednisolone Pulse Therapy by Mendoza Protocol in Primary and Secondary Nephrotic Syndrome (일차성 및 이차성 신증후군에서 Mendoza Protocol에 의한 Intravenous Methylprednisolone Pulse Therapy의 효과)

  • Lee Kyoung-Jae;Han Jae-Hyuk;Lee Young-Mock;Kim Ji-Hong;Kim Pyung-Kil
    • Childhood Kidney Diseases
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    • v.5 no.2
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    • pp.117-124
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    • 2001
  • Purpose : Since Mendoza(1990)'s report that long term methylprednisolone pulse therapy by Mendoza protocol (MP therapy) is a good treatment option in focal segmental glomerulosclerosis(FSGS), there have been reports of the effects of this therapy in steroid-resistant nephrotic syndrome. However, no studies have been performed on the effects of MP therapy in steroid- dependent nephrotic syndrome and secondary nephrotic syndrome. In this study, we investigated the effects of long term MP therapy in primary and secondary nephrotic syndrome in which previous treatment options were not effective. Methods : We chose 10 children who were diagnosed with steroid-dependent minimal change nephrotic syndrome(SD-MCNS), who had shown frequent relapse during the immunocompromised or cytotoxic therapy Period, and 6 children with FSGS and 5 children with secondary nephrotic syndrome children, who had shown no response during the previous therapy period. We treated these patients according to Mendoza protocol involving infusions of high doses of methylprednisolone, often in combination with oral cyclophosphamide for 82 weeks. Results : In all the 10 children with SD-MCNS, complete remission was visible on average of $18{\pm}9$ days after MP therapy was started. However, all these children relapsed during or after MP therapy. In these children, the mean relapse rate prior to MP therapy was $2.1{\pm}1.0$ relpases/year, which was reduced to $1.4{\pm}0.9$ relapses/year during MP therapy(P>0.05) and rose to $2.7{\pm}1.0$ relapse/year after MP therapy. Of the 6 children with FSGS, 4 children($67\%$) showed complete remission, of whom 3 children($50\%$) remained in the remission status during the follow up period, $1.2{\pm}0.7$ years, after the end of MP therapy. 2 children($33\%$) showed no response. All of the 5 children with secondary nephrotic syndrome showed remission and remained in the remissiom status during the follow up period, $1.7{\pm}0.6$ years The only side effect of MP therapy was transient hypertension in 10 children of ail subjects during the intravenous infusion of methylprednisolone. Conclusion : We conclude that although long term MP therapy is not effective in the treatment of SD-MCNS, it is an effective therapy against intractable FSGS and secondary nephrotic syndrome. (J Korean Soc Pediatr Nephrol 2001 ; 5 : 117-24)

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Results of radiofrequency catheter ablation in children and adolescent with tachyarrhythmia (소아 청소년 부정맥 환자에서 고주파 전극도자 절제술의 이용 성적)

  • Chang, Young Beom;Lee, Seung Hyun;Kang, Eun Young;Rhee, Kyoung-Suk;Joo, Chan Uhng
    • Clinical and Experimental Pediatrics
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    • v.50 no.11
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    • pp.1085-1090
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    • 2007
  • Purpose : Radiofrequency catheter ablation (RFCA) has become an effective therapeutic modality for treating pediatric tachyarrhythmias. Using conventional RFCA catheters, ablation of parahisian accessory pathways may be difficult and have high risk for heart block. We reviewed the efficacy and complications of the RFCA in children and adolescent with arrhythmias including parahisian accessory pathways. Methods : We studied 48 patients (aged 2 years to 20 years) who had undergone RFCA from August 2003 to March 2007. We reviewed clinical findings, electrophysiologic studies, RFCA data, complications, and follow-up results of the patients. Results : Mean age of the patients was 13.1 years. Numbers and types of arrhythmias (age, acute success rate) were as follows: 19 WPW syndrome including 5 parahisian accessory pathways ($13.7{\pm}4.6yr$, 18/19), 11 atrioventricular reentrant tachycardia with concealed bypass tract ($12.3{\pm}5.0yr$, 10/11), 13 atrioventricular nodal reentrant tachycardia ($12.6{\pm}4.4yr$, 13/13), 4 atrial flutter ($13.0{\pm}7.4yr$, 3/4), and 1 ventricular tachycardia (20 yr, 1/1). Associated cardiac structural lesion was not detected in 48 patients. The recurrence rate was 6.5%, and the final success rate was 93.8%. Conclusion : These results suggest that RFCA is a highly effective treatment method in children and adolescent with tachyarrhythmia.

Arthroscopic Excisional Debridement of Cyst-like lesion in juxta-articular Knee Joint (관절경을 이용한 슬관절주위 낭종유사 병변의 절제제거술)

  • Ko, Sang-Hun;Cho, Sung-Do;Kim, Jong-Oh
    • Journal of the Korean Arthroscopy Society
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    • v.7 no.1
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    • pp.70-75
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    • 2003
  • Purpose : A cyst-like lesion within and around the knee joint is very rare, with very few articles available in the literature. The aim of this study is to evaluate effectiveness of arthroscopic treatment of cyst-like lesion within and around the knee joint which reported rarely. Materials and Methods : We are reporting 14 cases of cyst-like lesion around the knee joint. Our cases include 3 ganglion cyst in infrapatellar fat pad, 1 fibroma, 1 giant cell tumor and 1 epidermoid cyst which have not yet been reported. The diagnosis of cyst-like lesion in Juxta-articular knee Joint was made only by MRI study and we confirmed pathology. Male was 9, female was 5 cases, average age was 24(11-43)year old. Follow up was average 45(12months-8years)months. Minimum follow up was 12 months. Results : All the patients were treated arthroscopic excisional debridements successfully. All the cases were excellent result in last follow up by functional criteria in Lysholm knee score average 98.9(95-100). All examimation was normal except 3 cases in last follow up. But all patients satisfied in arthroscopic treatment. Conclusion : Arthroscopic excisional debridement of the cyst-1ike lesion in juxta-arthcular knee joint is excellent method, but long term follow up needed in the future.

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A Case of Acute Eosinophilic Pneumonia (급성 호산구성 폐렴 1예)

  • Lee, Ki-Hoon;Cho, Chul-Ho;Koh, Kwang-Kon;Moon, Tai-Hoon;Jang, Dong-Seob;Park, Chan-Sup;Kim, Jin-Joo;Kim, Joon-Mee
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.1
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    • pp.99-104
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    • 1995
  • Most cases of eosinophilic pneumonia reported previously have followed a chronic course. The case presented here was acute in onset, suggesting a acute eosinophilic pneumonia. A model of criteria for acute and chronic eosinophilic pneumonia was made by Umeki in 1992. A previously healthy young man presented with cough, sputum, fever, and multiple small nodules on the chest radiograph. We confirmed eosinophilic pneumonia with bronchoalveolar lavage analysis and transbronchial lung biopsy. This case examplifies the recently descrived acute eosinophilic pneumonia.

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Surgical Management for Chronic Atrial Fibrillation (만성 심방세동에 대한 외과적 치험 4례)

  • 강경훈;김철환;김병열
    • Journal of Chest Surgery
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    • v.31 no.1
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    • pp.59-65
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    • 1998
  • Atrial fibrillation is the most common of all cardiac arrhythmias. It is associated with significant morbidity and mortality and is frequently resistant to medical therapy. On the experimental and clinical study, the presence of macroreentrant circuits and the absence of either microreentrant circuits or evidence of atrial automaticity suggests that atrial fibrillation should be amenable to surgical ablation. The results of the maze III procedure are associated with a higher incidence of postoperative sinus rhythm, improved long-term sinus node function, fewer pacemaker requirements, less arrhythmia recurrence, and improved long-term atrial transport function. We had experienced 4 patients with chronic atrial fibrillation. For the first time, Hioki procedure had been performed in the first patient with ASD and atrial fibrillation, regular sinus rhythm showed on postoperative EKG, but junctional rhythm and bradycardia developed postoperative 3 years. The maze III procedure for the rest with mitral valvular disease and atrial fibrillation had been done, followed by regular sinus rhythm for 2 patients and atrial fibrillation for 1 patient, managed with amiodarone, on immediate postoperative state. Echocardiogram documented good contraction of right atrium and hardly contraction of left atrium for 2 patients with regular sinus rhythm postoperative 3 months.

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