Papineau's technique represents an excellent method of dealing with serious bone infections with significant bone and soft tissue loss. The procedure is carried out in three stages: the 1st stage is the excision of infected bone and soft tissue, stabilization of the fracture site, the 2nd stage is the cancellous bone grafting, and the 3rd stage is the skin coverage. During the period from June 1980 to September 1982, our limited experience with 14 cases has been extremely satisfactory; 1. This method is applicable to traumatic osteomyelitis and some cases in which the infection has been blood borne. 2. Successful bone grafting in the presence of infection depends upon; a. complete sequestrectomy and removal of all infected tissue b. an adequate vascular bed for the graft c. no dead space d. sufficient immobilization.
Bone Transplantation ; Immobilization ; Methods ; Osteomyelitis ; Skin ; Transplants

Fractures of the femoral neck in children are rare and usually occur as a result of severe trauma. They are one of the most challenging injuries to treat. Their complication rate is high and their anatomic and physiologic characteristics make treatment difficult. The commonly encountered complications are avascular necrosis, nonunion, coxa vara and premature fusion of epiphyseal plate. Treatment of these fractures remains an unsolved problem but accurate reduction held with adequate internal fixation would appear to offer the best chance for succesful results. We report our observations in the treatment of eighteen cases of fracture of the femoral neck in children. Included is a review of references. The results obtained are as follows: 1. Among 18 patients, 11 were boys and 7 were girls. the highest incidence was between the ages of 5 and 7 years. 2. The main causes of fractures were traffic accidents in 10 cases (55.5%), falling from a height, and slipping down. 3. The commonest type of fracture was the cervicotrochanteric type (47.4%). Twelve cases were displaced fractures (66.7 %). 4. The range of Pauwels angle varied from 20° to 70°. 5. The commonly associated injuries were pelvic bone fractures, extremity fractures, skull fractures and soft tissue injuries. 6. Nine cases were treated by skin traction and plaster cast. Five cases ere treated by closed reduction and internal fixation with K-wires or knowles pins. 7. In 13 of the 18 cases, follow-up studies were done for an average period of 18 months. 8. The results were analyzed according to the Ratliffs assessment. Among the 13 cases, 10 cases showed good results, two fair and one poor. 9. All cases treated by closed reduction and internal fixation showed good results without complications. 10. Complications developed in five cases (38.5%), three cases of avascular necrosis and two cases of coxa vara. Among these five cases, one case of avascular necrosis developed as a result of neglect of the fracture and the others as a result of too conservative a treatment. 11. Secondary treatment of trochanteric arthroplasty was required in only one neglected case. This was further by avascular necrosis and the results were poor. 12. As a result, we recommond closed reduction and internal fixation as the most favorable method of treatment for the fracture of the femoral neck in children.
Accidental Falls ; Accidents, Traffic ; Arthroplasty ; Casts, Surgical ; Child ; Clinical Study ; Coxa Vara ; Extremities ; Female ; Femur ; Femur Neck ; Follow-Up Studies ; Growth Plate ; Humans ; Incidence ; Methods ; Necrosis ; Pelvic Bones ; Skin ; Skull Fractures ; Soft Tissue Injuries ; Traction

STATEMENT OF PROBLEM: In cases where bony defects were present, guided bone regenerations have been performed to aid the placement of implants. Nowadays, the accepted concept is to isolate bone from soft tissue by using barrier membranes to allow room for generation of new bone. Nonresorbable membranes have been used extensively since the 1980's. However, this material has exhibited major shortcomings. To overcome these faults, efforts were made to develop resorbable membranes. Guided bone regenerations utilizing resorbable membranes were tried by a number of clinicians. Bio-Gide. is such a bioresorbable collagen that is easy to use and has shown fine clinical results. PURPOSE: The aim of this study was to evaluate the histological results of guided bone regenerations performed using resorbable collagen membrane(Bio-Gide.) with autogenous bone, bovine drived xenograft and combination of the two. Surface morphology and chemical composition was analyzed to understand the physical and chemical characteristics of bioresorbable collagen membrane and their effects on guided bone regeneration. MATERIAL AND METHODS: Bioresorbable collagen membrane (Bio-Gide.), Xenograft Bone(Bio-Oss), Two healthy, adult mongrel dogs were used. RESULTS: 1. Bioresorbable collagen membrane is pure collagen containing large amounts of Glysine, Alanine, Proline and Hydroxyproline. 2. Bioresorbable collagen membrane is a membrane with collagen fibers arranged more loosely and porously compared to the inner surface of canine mucosa : This allows for easier attachment by bone-forming cells. Blood can seep into these spaces between fibers and form clots that help stabilize the membrane. The result is improved healing. 3. Bioresorbable collagen membrane has a bilayered structure : The side to come in contact with soft tissue is smooth and compact. This prevents soft tissue penetration into bony defects. As the side in contact with bone is rough and porous, it serves as a stabilizing structure for bone regeneration by allowing attachment of bone-forming cells. 4. Regardless of whether a membrane had been used or not, the group with autogenous bone and Bio-Oss. filling showed the greatest amount of bone fill inside a hole, followed by the group with autogenous bone filling, the group with blood and the group with Bio-Oss. Filling in order. 5. When a membrane was inserted, regardless of the type of bone substitute used, a lesser amount of resorption occurred compared to when a membrane was not inserted. 6. The border between bone substitute and surrounding bone was the most indistinct with the group with autogenous bone filling, followed by the group with autogenous bone and Bio-Oss. filling, the group with blood, and the group with Bio-Oss. filling. 7. Three months after surgery, Bio-Gide. and Bio-Oss. were distinguishable. CONCLUSION: The best results were obtained with the group with autogenous bone and Bio-Oss. filling used in conjunction with a membrane.
Adult ; Alanine ; Animals ; Autografts* ; Bone Regeneration ; Bone Substitutes ; Collagen* ; Dogs ; Guided Tissue Regeneration ; Heterografts* ; Humans ; Hydroxyproline ; Membranes* ; Mucous Membrane ; Proline ; Regeneration*

It has been studied that a variety of fauna and flora are sensitive biological indicators which reflect the severity of regional pollution of heavy metals, but in the center of part of Taegu city the controversial issue of lead poisoning attributable to the atmosphere which contains an increased concentrations of lead has been raised recently, it is usually hard to find suitable plants or animal in the areas with heavy traffic. Pigeons are ubiquitous in and around Taegu city area, inhabiting even the most densely populated areas with heavy traffic with its small body size, high metabolic turnover, and rather limited mobility, a pigeon, as a biological indicator is expected. This study was conducted to monitor lead pollution in the Taegu and kyongju city in Korea. We measured the lead content of the various tissue of three groups of feral pigeon(Columbia livia) and soil and atmospheric lead concentration. First group was obtained io heavy traffic area in Taegu City, the second group was obtained a park in Taegu city and the third group was obtained light traffic area in kyongju city. The air and soil lead concentration of heavy traffic area in Taegu city was 0.11 microgram/m2, 4.96 microgram/g, that of park in Taegu city was 0.05 microgram/m3, 2.65 microgram/g and that of light traffic area in kyonngju city was 0.03 microgram/m3, 0.01 microgram/g. The lead content of lung, blood, kidney, femur and liver of feral pigeons in heavy traffic area in Taegu city was significantly higher than pigeons obtained in a park in Taegu city and low traffic density area in Kyonfju city(p<0.01). But stomach lead content of three group did not reflect a significant difference. In this study positive correlation was found between atmospheric lead concentrations and the concentration of lead in the pigeon's lung(r=0.5040, p<0.001), blood(r=0.3322, p<0.01), kidney(r=0.4824, p<0.001), femur(r=0.7214, p<0.001) and liverer (r=0.4836, p<0.01). we can also found positive correlation between soil lead concentrations and the concentration of lead in the pigeon's femur(r=0.4850, p<0.001), kidney(r=0.4850, p<0.001) and liver(r=0.4386, p<0.01). In the pigeon`s tissue there were significant correlations between concentration of lead in the blood and kidney(r=0.4818, p<0.001), femur(r= 0.6157, p<0.001) and liver(r=0.3889, p<0.001). In conclusion, at the heavy traffic area in Taegu city, lead concentrations found in the atmosphere and soil are reflected in the lead concentrations of different tissue of urban pigeons. It is suggested that the tissue of pigeons can be good biological indicators of environmental lead pollution.
Animals ; Atmosphere ; Body Size ; Columbidae ; Daegu ; Femur ; Gyeongsangbuk-do ; Kidney ; Korea ; Lead Poisoning ; Liver ; Lung ; Metals, Heavy ; Soil* ; Stomach

The authors report two unusual tumors detected in the right scapula and around left aciatic nerve. Although fibromatosis is benign tumor, the nature is notorious for an aggreasive clinical couras with a tendency to recur in high percentage. Recently we have encountered two instances of fibromatosis, and presented with abort discussion of the clinical pathologic aspects with some review in literatures.
Fibroma ; Scapula

While a giant cell tumor most frequently involves the distal end of the femur and proximal end of the tibia, involvement of the cervical spine is quite rare. Recently we observed a patient with a giant cell tumor affecting the sixth cervical vertebra. This is regarded as a clinically malignant tumor because its nature and difficulty in diagnosis and treatment We easily confirmed the extent of the lesion by CT scanning with Metrizamide. The treatment was palliative tumor ressection. This case of a giant cell tumor affecting the sixth cervical vertebra is reported with a brief review of the literature.
Diagnosis ; Femur ; Giant Cell Tumors ; Giant Cells ; Humans ; Metrizamide ; Spine ; Tibia ; Tomography, X-Ray Computed

130 cases of the suprarcondylar fractures of the humerus in children were analysed. 60 cases were immobilized with plaster splint without closed reduction. 22 cases were closedly reduced and immobilized with plaster splint. 47 cases were closedly reduced and were fixed percutaneously with K-wires. 39 cases were operatively reduced and were fixed with K-wires. The following results were obtained. 1. The average age was 7.9 years, and the male and female ratio was 2.7: 1. 2. The extension type was 96.2% and the flexion type was 3.8%. 3. The left side (64.6%) was more frequently involved. 4. As associated complications, nerve injury (4.6%), vascular injury (2.3%), open fracture (2.3%), and associated fracture (2.3%). were developed. During treatment incomplete ulnar nerve palsy (2.3%), pin tract superficial infection(3.1%), severe cubitus varus deformity(4.6%), severe limitation of elbow motion(11.6%) were also developed. 5. Final results in the Holmberg's 4 Groups according to Mitchell & Adams' criteria showed that the more the displacement of fracture is increased, the more the poor result is also increased. 6. In spite of the selection of the more severe cases for surgery, the results of the operative cases were better than those achieved by closed reduction in the easier cases. 7. In the displaced fractures, immediate open reduction brings the satisfactory results and minimizies the sequellae.
Child ; Elbow ; Female ; Fractures, Open ; Humans ; Humerus ; Male ; Splints ; Ulnar Neuropathies ; Vascular System Injuries

Thirty cases of segmental tibial fracture were treated during the period from January, 1980 to January, 1987. The following results were obtained. 1. Type I, high middle segment, was most common(16 cases, 52%). 2. High incidence of open fracture(22 cases, 71%). 3. Closed fractures were internally fixated whereas open ones, externally. 4. Higher union rates in intramedullary nailing. 5. External fixators, such as Monofixateur, were effective in severe open fractures.
Clinical Study ; External Fixators ; Fracture Fixation, Intramedullary ; Fractures, Closed ; Fractures, Open ; Incidence ; Tibia ; Tibial Fractures

This report dealt with the case of 58 year old male with thrombotic thrombocytopenic purpura syndrome. The patient had an occlusion of the left middle cerebral artery on the carotid angiogram. The clinical course of the case with disseminated intravascular coagulation was fulminant. Literatures on pathophysiology, treatment, pathology and clinical course disseminated intravascular coagulation were reviewed.
Disseminated Intravascular Coagulation* ; Humans ; Male ; Middle Aged ; Middle Cerebral Artery* ; Pathology ; Purpura, Thrombotic Thrombocytopenic

No abstract available.
Animals ; Macrophages ; Macrophages, Peritoneal* ; Mice* ; Signal Transduction*