No abstract available.
Genu Varum*

Vascular grafts are often required in clinical stiuations to bridge arterial or venous grafts. Numerous studies exist in the literature concerning the results of such arterial and venous graft of relatively large vessels. There are only a few reports dealing with experimental microvascular grafts. Histopathological features of the grafted vessels were studied after autogenous venous grafts,autogenous arterial grafts and venous allografts using microsurgical techniques. The results were summerized as follow. 1. The patency rate of grafted vessels by microsurgical techniques was 86.8%. 2. In autogenous venous grafts histopathological changes occur later, and to a less pronounced degree, than that in autogenous arterial grafts. 3. Venous allografts showed severe acute inflammatory reaction throughout the layer at 3~7 days postoperatively, but histopathological features of grafted vessels of autografts and venous allografts' did not differ each other in later results. 4. Autogenous venous grafts, autogenous arterial gtafts and venous allografts persist as living sucture but undergo certain histological changes consisting of fibrous reinforcement. 5. It may be said that histological examination of the specimen led general conclusion that the most useful microvascular graft to reestablish circulation of damaged vessels is the autogenous venous graft, but autogenous arterial graft and venous allograft are also applicable when autogenous venous tissue is not available.
Allografts ; Autografts ; Transplants

The treatment of extensive soft tissue injury of the lower extremities is known to be one difficulty in the field of orthopedic surgery. At present, reconstructive surgery with large cutaneous flaps is being employed, and the authors present 2 cases of a combination of flaps for extensive soft tissue injury of the lower extremity at the Department of Orthopedic Surgery of Severance Hospital during a 5 months period from June, 1983 to November, 1983. The results of the study are as follows: 1. A one-stage reconstruction of extensive soft tissue injury was done with a combination of a scapular and a latissimus dorsi flap. 2. There was no limitation of motion of the shoulder in spite of the excision of the scapular and the latissimus dorsi flaps around the axillary area. 3. The primary closure of the donor flap sites was feasible. 4. The reconstructive surgery of the extensive soft tissue injury using the above combination of the scapular and latissimus dorsi flaps can be used without restriction as to the age of the patient.
Humans ; Lower Extremity ; Orthopedics ; Shoulder ; Soft Tissue Injuries ; Superficial Back Muscles ; Tissue Donors

No abstract available.

Chondroblastoma is a rare primary neoplasm of bone which involves the epiphysis of the long bone and develops mostly in the 2nd decade of life. We reviewed the cases of twenty patients with chondroblastoma who were treated at the Department of Orthopaedic Surgery, Yonsei University College of Medicine between 1969 and 1989. All patients were followed for 1 year or longer. The results were as follows. 1. The proximal end of the humerus(25%) and the proximal end of the femur(25%) were the most common sites. 2. 85% of patients were between 11 to 20 years old and male to female ratio was 3:2. 3. The most common symptom was pain and in 30% of patients it was appeared after minor trauma. 4. The average diameter of lesion is 4.2cm in its long axis and the more longer the duration, the more larger the size of lesion. 5. Involvement of the epiphyseal plate was twice as common in the patients with a closing plate as in those with an open one. 6. The most common microscopic finding was the presence of chondroblast and chondroid matrix. 7. Two patients(10%) had a local recurrence. 8. The final functional results were considered to be good in sixteen(80%) patients. 9. Accurste localization of the lesion during biopsy is very important especially in the case of deep seated lesion.
Biopsy ; Chondroblastoma ; Chondrocytes ; Epiphyses ; Female ; Growth Plate ; Humans ; Male ; Recurrence

Although many techniques are available to assess enamel erosion in vitro, a simple, non-destructive method with sufficient sensitivity for quantifying dental erosion is required. This study characterized the bovine dental enamel erosion induced by various acidic beverages in vitro using attenuated total reflection Fourier transform infrared (ATR-FTIR) spectroscopy. Deionized water (control) and 10 acidic beverages were selected to study erosion, and the pH and neutralizable acidity were measured. Bovine anterior teeth (110) were polished with up to 1 200-grit silicon carbide paper to produce flat enamel surfaces, which were then immersed in 20 mL of the beverages for 30 min at 37 °C. The degree of erosion was evaluated using ATR-FTIR spectroscopy and Vickers’ microhardness measurements. The spectra obtained were interpreted in two ways that focused on the ν1, ν3 phosphate contour: the ratio of the height amplitude of ν3 PO4 to that of ν1 PO4 (Method 1) and the shift of the ν3 PO4 peak to a higher wavenumber (Method 2). The percentage changes in microhardness after the erosion treatments were primarily affected by the pH of the immersion media. Regression analyses revealed highly significant correlations between the surface hardness change and the degree of erosion, as detected by ATR-FTIR spectroscopy (Po0.001). Method 1 was the most sensitive to these changes, followed by surface hardness change measurements and Method 2. This study suggests that ATRFTIR spectroscopy is potentially advantageous over the microhardness test as a simple, non-destructive, sensitive technique for the quantification of enamel erosion.

Intramural duodenal hematoma (IDH) is a quite rare disese entity which results from the collection of blood and body fluid between mucosa and serosa. Various degrees of duodenal obstruction may be caused by IDH as it gradually enlarges and compresses the mucosa against the opposite side of duodenum. The most common cause of IDH is blunt abdominal trauma and the spontaneous IDHs are generally casused by coagulation disorder such as blood dyscrasia, anticoagulation treatment or pancreaticoduodenal aneurysm. The diagnosis is usually made by the typical imaging on abdominal computed tomographic scan with a previous history of blunt abdominal trauma. For spontaneous IDH without coagulation disorder, an abdominal angiogram may be considered to exclude vascular anomalies. Medical treatment is recommended unless the associated visceral injuries require immediate laparotomy. Here, we report a case of acute duodenal obstruction due to IDH which had resolved completely without an operative management.
Aneurysm ; Body Fluids ; Diagnosis ; Duodenal Obstruction* ; Duodenum ; Hematoma* ; Laparotomy ; Mucous Membrane ; Serous Membrane

BACKGROUND: The purpose of this study was to investigate the clinical and electro physiologic characteristics of patients with multiple accessory pathways. Recently as endocardial mapping has become more and more accurate, multiple accessory pathways which were considered to be rare in the past, have become more commonly reported in patients with Wolff-Parkinson-White syndrome. METHODS: From February 1993 to June 2000, there were a total of 452 patients, who were confirmed to have accessary pathway mediated-tachyarrhythmias diagnosed by electrophysiologic study. Among those, 19 patients had multiple accessory pathways, and were enrolled in this study. RESULTS: Among the 19 patients, thirteen patients were male and six were female, and their mean age was 36.5+/-16.17 years. All patients had 2 accessory pathways. The distribution of the location of the accessory pathways was at the left free wall (71.1%), right free wall (18.4%) and posteroseptal wall (10.5%). The most common combination pattern was the left free wall and left free wall (57.9%) and the most common anatomical areas were the left lateral wall and left posterior wall (36.8%). The success rate of the catheter ablation was 84.2% (16/19). The recurrence rate after the radiofrequency catheter ablation was 31.3% (5/16) and the most common recurrence site was left free wall (60.0%, 3/5). CONCLUSION: These results indicated that the clinical and electrophysiologic characteristics of the multiple accessory pathway patients with WPW syndrome in our study were similar to those of western countries.
Catheter Ablation ; Female ; Humans ; Male ; Recurrence ; Wolff-Parkinson-White Syndrome

PURPOSE: Fine needle aspiration (FNA) is a useful preoperative diagnostic tool for thyroid nodule because of the high sensitivity and specificity. The aim of this study is to determine the necessity of intraoperative frozen section (IOFS) after fine needle aspiration. METHODS: Data of 534 patients with a single thyroid nodule who underwent thyroidectomy from June 2006 to August 2013 were reviewed retrospectively. FNA was performed preoperatively in all patients and IOFS was performed selectively according to the intraoperative findings and FNA results. The sensitivity, specificity, positive predictive value, negative predictive value and accuracy of FNA and IOFS for malignant nodules were analyzed. RESULTS: The sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of FNA for malignant nodules were 100%, 95.5%, 99.8%, 100%, and 99.8%, respectively. All nodules diagnosed as benign by FNA were reaffirmed as benign nodules by permanent sections. When the result of FNA was suspicious for malignancy, specific features of preoperative ultrasound, including hypoechoic, size<10 mm showed high positive predictive value and accuracy (98%, 86.9%, and 100%, 78.7% respectively). CONCLUSION: Performance of IOFS was not necessary when the result of FNA was consistent with malignancy or benign. However when the result of FNA was non-diagnostic or atypia, IOFS should be performed for more accurate detection of malignancy. When the result of FNA is suspicious for malignancy, IOFS is restrictively useful for excluding benign nodules using the features of ultrasound. In addition, IOFS is not useful in finding malignant thyroid nodules when the result of FNA is follicular neoplasm.
Biopsy, Fine-Needle* ; Frozen Sections* ; Humans ; Retrospective Studies ; Sensitivity and Specificity ; Thyroid Gland* ; Thyroid Nodule* ; Thyroidectomy ; Ultrasonography

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